Provider Demographics
NPI:1619925906
Name:LOWELL, LANDI FRANCES (MD)
Entity type:Individual
Prefix:DR
First Name:LANDI
Middle Name:FRANCES
Last Name:LOWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LANDI
Other - Middle Name:FRANCES
Other - Last Name:HALLORAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 3046
Mailing Address - Street 2:
Mailing Address - City:GILLETTE
Mailing Address - State:WY
Mailing Address - Zip Code:82717-3046
Mailing Address - Country:US
Mailing Address - Phone:307-688-2600
Mailing Address - Fax:307-685-3079
Practice Address - Street 1:501 S BURMA AVE
Practice Address - Street 2:
Practice Address - City:GILLETTE
Practice Address - State:WY
Practice Address - Zip Code:82716-3426
Practice Address - Country:US
Practice Address - Phone:307-688-3636
Practice Address - Fax:765-658-2703
Is Sole Proprietor?:No
Enumeration Date:2006-05-05
Last Update Date:2017-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01057339A207RA0000X
WY7954A207R00000X, 207RA0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RA0000XAllopathic & Osteopathic PhysiciansInternal MedicineAdolescent Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5241531OtherCIGNA
IN000000291999OtherANTHEM
IN200425080Medicaid
IN200425080Medicaid
IN94041017Medicare ID - Type Unspecified