Provider Demographics
NPI:1023104320
Name:FOWLER, JULIA ANN (MD)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:ANN
Last Name:FOWLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9000 BAILEY COVE RD
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802
Mailing Address - Country:US
Mailing Address - Phone:256-882-7335
Mailing Address - Fax:256-882-7325
Practice Address - Street 1:9000 BAILEY COVE RD SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-4002
Practice Address - Country:US
Practice Address - Phone:256-882-7335
Practice Address - Fax:256-882-7325
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL14144207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000029602Medicaid
AL000029602Medicare ID - Type Unspecified
ALC72231Medicare UPIN