Doctor Name: | THOMAS A KOWAL |
NPI Number: | 1043205008 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | 30964 |
Business Practice Address: | 1037 W Main St Suite A Lebanon, TN - 370873355 |
Business Phone Number: | 6154533567 |
Business Fax Number: | 6154534031 |
Mailing Address: | 1037 W Main St, Suite A LEBANON |
State: | TN |
Postal Code: | 370873355 |
Phone Number: | 6154533567 |
Fax Number: | 6154534031 |
NPI Enumeration Date: | 09/15/2005 |
NPI Last Update Date: | 01/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 30964 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TN |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |