Provider Demographics
NPI:1487978334
Name:VICKIE C. LOWE, M.D., PSC
Entity type:Organization
Organization Name:VICKIE C. LOWE, M.D., PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:VICKIE
Authorized Official - Middle Name:CAROL
Authorized Official - Last Name:LOWE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:270-769-3100
Mailing Address - Street 1:134 HEARTLAND DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-2778
Mailing Address - Country:US
Mailing Address - Phone:270-769-3100
Mailing Address - Fax:270-234-0753
Practice Address - Street 1:134 HEARTLAND DR
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-2778
Practice Address - Country:US
Practice Address - Phone:270-769-3100
Practice Address - Fax:270-234-0753
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-22
Last Update Date:2010-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY27635208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY1048984OtherPASSPORT
KY64276355Medicaid
KY250006816OtherRAILROAD MEDICARE
KY000000050299OtherANTHEM
KY2432324000OtherPASSPORT ADVANTAGE
KY163857500OtherDEPARTMENT OF LABOR
KY250006816OtherRAILROAD MEDICARE
KY01435Medicare PIN