Individual provider · Type 1 NPI

Cody Fowler, P.A.-C

Surgical Physician Assistant · Idaho Falls, ID

NPI number 1386018950 Active

Practice location

3345 Potomac Way
Idaho Falls, ID 83404-4978

Call (208) 552-7572 Map

Fax (208) 552-7312

Mailing address

PO Box 277381
Atlanta, GA 30384-7381

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XPA-1326 (ID)

Surgical Physician Assistant: Definition to come...

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About NPI 1386018950

Cody Fowler, P.A.-C's National Provider Identifier is 1386018950, issued on Nov 19, 2015. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Idaho Falls, ID. The record was last updated on Feb 8, 2022.