Active NPI
Evan Alsbury Fowler, DO
- Student in an Organized Health Care Education/Training Program
- Perrysburg, OH
National Provider Identifier
1689369019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- 58.033581
- Practice address
- 7045 Lighthouse Way
Perrysburg, OH 43551-7000 - Phone
- (419) 794-9292
- NPI assigned
- Apr 11, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | 58.033581 | OH | Primary |
Addresses
Primary practice location
7045 Lighthouse Way
Perrysburg, OH 43551-7000
Mailing address
4947 Chapel Xing
Douglasville, GA 30135-2689
Phone (404) 863-2894
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Osteopathy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 58.033581 | OH | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1681171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1681171200000",
"number": "1689369019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4947 CHAPEL XING",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301352689",
"telephone_number": "404-863-2894"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7045 LIGHTHOUSE WAY",
"city": "PERRYSBURG",
"state": "OH",
"postal_code": "435517000",
"telephone_number": "419-794-9292"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLER",
"first_name": "EVAN",
"middle_name": "ALSBURY",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-04-11",
"last_updated": "2023-04-11",
"certification_date": "2023-03-31",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "OH",
"license": "58.033581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Perrysburg, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.