Provider Demographics
NPI:1538531868
Name:ROWE, CALEB (PA-C)
Entity type:Individual
Prefix:
First Name:CALEB
Middle Name:
Last Name:ROWE
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 BURT RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-2457
Mailing Address - Country:US
Mailing Address - Phone:859-276-1511
Mailing Address - Fax:859-276-2556
Practice Address - Street 1:177 BURT RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2457
Practice Address - Country:US
Practice Address - Phone:859-276-1511
Practice Address - Fax:859-276-3373
Is Sole Proprietor?:No
Enumeration Date:2015-10-26
Last Update Date:2021-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPA2051363AM0700X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical