Lowder, Jerry Lane

Lowder, Jerry Lane is an individual health care provider with primary practice located at 4901 Forest Park Ave Div Obgyn Pelvic Med/Reconstruct Surg, Ste 710, Saint Louis MO 63108-1495. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery. Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery is his primary health care specialty. Lowder, Jerry Lane can be contacted via phone (314) 747-1402.

Contact Information

Primary practice address
4901 Forest Park Ave Div Obgyn Pelvic Med/Reconstruct Surg, Ste 710 Saint Louis MO 63108-1495
Phone: (314) 747-1402
Fax: (314) 362-3328
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 2013044288 Missouri
Allopathic & Osteopathic Physicians / Female Pelvic Medicine and Reconstructive Surgery 207VF0040X 2013044288 Missouri

Profile Details

NPI number 1619941879
LBN Legal business name Lowder, Jerry Lane
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 15th, 2006
Last updated Apr 25th, 2024 - about 7 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619941879 NPPES
Missouri MEDICAID 200011086

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