Active NPI
Marjorieb B Fowlkes, M.D.
- Family Medicine Physician
- Bozeman, MT
National Provider Identifier
1932276367
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 3896
- Practice address
- Student Health Service
Montana State University
Bozeman, MT 59715 - Phone
- (406) 994-2311
- NPI assigned
- Nov 29, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 3896 | MT | Primary |
Addresses
Primary practice location
Student Health Service
Montana State University
Bozeman, MT 59715
Mailing address
31 Gardner Park Dr
Bozeman, MT 59715-9229
Phone (406) 587-0192
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 Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3896 | MT | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1164758400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1932276367",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "31 GARDNER PARK DR",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "597159229",
"telephone_number": "406-587-0192"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "STUDENT HEALTH SERVICE",
"address_2": "MONTANA STATE UNIVERSITY",
"city": "BOZEMAN",
"state": "MT",
"postal_code": "59715",
"telephone_number": "406-994-2311"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FOWLKES",
"first_name": "MARJORIEB",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-29",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MT",
"license": "3896",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bozeman, MT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.