JEFFREY V FOWLER DO PROF LLC (NPI# 1033163415) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033163415 |
| Entity Type | Organization |
| Organization Name | JEFFREY V FOWLER DO PROF LLC |
| Practice Address |
4728 Eagleridge Cir Pueblo CO 81008-2195 |
| Practice Telephone | 7195832300 |
| Practice Fax Number | 7195832301 |
| Mailing Telephone | 7195832300 |
| Mailing Fax Number | 7195832301 |
| Enumeration Date | 2006-05-20 |
| Last Update Date | 2012-01-24 |
| Authorized Official Name | LORI FOWLER (OFFICE MANAGER) |
| Authorized Official Telephone | 7195832300 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207V00000X | Obstetrics & Gynecology | 40720 | CO | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CO | 19787359 | 05 |
| Street Address |
4728 EAGLERIDGE CIR |
| City | PUEBLO |
| State | CO |
| Zip Code | 81008-2195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164058913 | Healthone Clinic Services - Oncology Hematology LLC | Internal Medicine | 3678 Parker Blvd, Pueblo, CO 81008 | 2020-03-12 |
| 1073026423 | Carmel Community Living Corporation | Respite Care | 2003 Northmoor Terrace, Suite 100, Pueblo, CO 81008 | 2017-11-08 |
| 1568987121 | Hannah Vivian Roadruck | Pharmacist | 4200 Dillon Dr., Pueblo, CO 81008 | 2017-08-04 |
| 1184170425 | Brett Burana | Dentist | 729 Us-50, Pueblo, CO 81008 | 2016-08-28 |
| 1760832885 | Irby Dental Cottage | Dental Hygienist | 2099 West St # 50, Suite 180, Pueblo, CO 81008 | 2016-06-20 |
| 1649624362 | Curley Peak Dentistry Pllc | Dentist | 1640 W Fortino Blvd, Pueblo, CO 81008 | 2016-04-19 |
| 1336507847 | Kyle Tipton | Nurse Anesthetist, Certified Registered | 4741 Eagleridge Circle, 206, Pueblo, CO 81008 | 2016-01-29 |
| 1407211931 | Center At Park West, LLC | Skilled Nursing Facility | 3727 Parker Blvd., Pueblo, CO 81008 | 2015-12-29 |
| 1417327461 | Nicole Betts | Registered Nurse | 1310 Fortino Blvd Ste D, Pueblo, CO 81008 | 2015-10-02 |
| 1437578028 | Pueblo Modern Dentistry and Orthodontics, LLP | Dentist | 727 Us Hwy 50 West, Pueblo, CO 81008 | 2014-04-10 |
| Find all providers in zip 81008 | ||||
| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548802747 | Parkview Ancillary Services | Obstetrics & Gynecology | 1501 Court, Pueblo, CO 81003-2720 | 2019-10-09 |
| 1891714713 | James E Roukema | Obstetrics & Gynecology | 4010 Jerry Murphy Rd, Pueblo, CO 81001-1045 | 2006-07-19 |
| 1720015324 | Leslie Ginger Frederiksen | Obstetrics & Gynecology | 4010 Jerry Murphy Road, Pueblo, CO 81001-1045 | 2006-06-27 |
| 1447245139 | Brett L Hulet | Obstetrics & Gynecology | 300 Colorado Ave, Pueblo, CO 81004 | 2005-09-19 |
| 1083609796 | Pueblo Assoc In Ob & Gyn PC | Obstetrics & Gynecology | 1120 Minnequa Ave, Pueblo, CO 81004-3734 | 2005-09-19 |
| 1992347256 | Parkview Ancillary Services | Obstetrics & Gynecology | 4010 Jerry Murphy Road, Pueblo, CO 81001-1045 | 2019-10-08 |
| 1295385987 | Catholic Health Initiatives Colorado | Obstetrics & Gynecology | 729 E Spaulding Ave, Pueblo, CO 81007-3512 | 2019-09-16 |
| 1366092389 | Parkview Ancillary Services | Obstetrics & Gynecology | 1600 N Grand Ave Ste 400, Pueblo, CO 81003-2760 | 2019-09-12 |
| 1376926725 | Kruti Shivlal Patel | Obstetrics & Gynecology | 1600 N Grand Ave Ste 400, Pueblo, CO 81003-2760 | 2015-07-02 |
| 1558744359 | Elliott Bradley Courter | Obstetrics & Gynecology | 902 Lakeview Ave, Pueblo, CO 81004-3597 | 2015-06-30 |
| Find all providers in PUEBLO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.