Provider Demographics
NPI:1134336886
Name:LOWTHER, KEISHA GIBSON (MD)
Entity type:Individual
Prefix:
First Name:KEISHA
Middle Name:GIBSON
Last Name:LOWTHER
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 1:6531 HIGHWAY 69 S
Mailing Address - Street 2:SUITE A
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35405-4087
Mailing Address - Country:US
Mailing Address - Phone:205-343-6979
Mailing Address - Fax:
Practice Address - Street 1:6531 HIGHWAY 69 S
Practice Address - Street 2:SUITE A
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35405-4087
Practice Address - Country:US
Practice Address - Phone:205-343-6979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-16
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL26476208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine