Provider Demographics
NPI:1174571822
Name:LOWRY, ORLANDA RAYMOND III (MD)
Entity type:Individual
Prefix:
First Name:ORLANDA
Middle Name:RAYMOND
Last Name:LOWRY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1432 DARBEE DR
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3323
Mailing Address - Country:US
Mailing Address - Phone:423-581-3160
Mailing Address - Fax:
Practice Address - Street 1:1432 DARBEE DR
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:TN
Practice Address - Zip Code:37814-3323
Practice Address - Country:US
Practice Address - Phone:423-581-3160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-05
Last Update Date:2009-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD5167207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN31482191OtherMEDICARE ID-PTAN
TN31482191OtherMEDICARE ID-PTAN