DR. RICHARD J FOWL (NPI# 1235114711) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1235114711 |
| Entity Type | Individual |
| Full Name | DR. RICHARD J FOWL |
| Credential | M.D. |
| Practice Address |
5779 E Mayo Blvd Phoenix AZ 85054-4502 |
| Practice Telephone | 4803018000 |
| Mailing Telephone | 4803018000 |
| Enumeration Date | 2005-12-07 |
| Last Update Date | 2007-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0129X |
Surgery Specialization: Vascular Surgery |
23566 | AZ | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| AZ | 336421 | 05 | |
| AZ | TRIWEST | 86080015085259A054 | 01 |
| Street Address |
5779 E MAYO BLVD |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85054-4502 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043219389 | Hasan Khamash | Internal Medicine | 5779 E Mayo Blvd, Phoenix, AZ 85054 | 2005-07-19 |
| 1831709393 | Sarah Jayne Refner | Nurse Practitioner | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-08-08 |
| 1780215616 | Amy Kole | Physician Assistant | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2020-01-29 |
| 1174083075 | Jee Kim | Student in an Organized Health Care Education/Training Program | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2019-03-25 |
| 1902315435 | Stacie Attig | Registered Nurse | 5779 E Mayo Blvd, Phoenix, AZ 85054 | 2017-09-27 |
| 1386906667 | Rudy Rahme | Neurological Surgery | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2012-06-12 |
| 1083904221 | Deborah S Dossick | Student in an Organized Health Care Education/Training Program | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2011-04-08 |
| 1477863298 | Shari T Perez | Nurse Practitioner | 5779 E Mayo Blvd, Phoenix, AZ 85054 | 2010-10-14 |
| 1427367473 | Shawna Sando Boyle | Physician Assistant | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2010-09-24 |
| 1851609309 | Jaime L Engholdt | Physician Assistant | 5779 E Mayo Blvd, Phoenix, AZ 85054-4502 | 2010-09-17 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992255301 | Stephanie Gamber | Registered Nurse | 5405 East Pinnacle Vista Drive, Phoenix, AZ 85054 | 2016-10-10 |
| 1508231960 | Deborah Elam | Acupuncturist | 5777 East Mayo Boulevard Mayo Clinic, Phoenix, AZ 85054 | 2015-12-09 |
| 1811176860 | Desert Ridge Pediatric Dentistry | Clinic/Center | 5315 E. High Street, Suite 115, Phoenix, AZ 85054 | 2007-10-26 |
| 1902968639 | Ryan David Schulze | Chiropractor | 7000 E Mayo Blvd Ste 1058, Phoenix, AZ 85054 | 2006-12-16 |
| 1477517423 | Gary Betz II Md PC | Internal Medicine | 7010 E. Chauncey Lane, Suite 145, Phoenix, AZ 85054 | 2006-04-14 |
| 1689658395 | Alice G Mccormick | Internal Medicine | 5450 East Deer Valley Drive Unit 3206, Phoenix, AZ 85054 | 2005-12-06 |
| 1770576241 | Michelle Renee Kuhn | Physician Assistant | 6950 E Chauncey Ln, Phoenix, AZ 85054 | 2005-08-30 |
| 1609869981 | Jeffrey Alan Smith | Optometrist | 18325 N Allied Way Ste 100, Phoenix, AZ 85054 | 2005-08-23 |
| 1497753750 | Rajeev Agarwal | Pediatrics | 7010 E Chauncey Ln, Suite 225, Phoenix, AZ 85054 | 2005-07-11 |
| 1740283878 | Charles J Manak | Internal Medicine | 5777 E Mayo Blvd, Phoenix, AZ 85054 | 2005-05-23 |
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| Taxonomy Code | 2086S0129X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Vascular Surgery |
| A surgeon with expertise in the management of surgical disorders of the blood vessels, excluding the intracranial vessels or the heart. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Surgery, 2007. http://www.absurgery.org/. American Osteopathic Board of Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649894890 | Honorhealth Ambulatory | Surgery | 9250 N 3rd St Ste 2000, Phoenix, AZ 85020-2403 | 2020-06-03 |
| 1275157414 | Honorhealth Ambulatory | Surgery | 18404 N Tatum Blvd Ste 201, Phoenix, AZ 85032-1508 | 2020-06-03 |
| 1467744490 | Martin Paul Zomaya | Surgery | 3033 N Central Ave Ste 610, Phoenix, AZ 85012 | 2011-05-10 |
| 1326230681 | Salaheddine Tomeh Md PC | Surgery | 333 W Thomas Rd Ste 201, Phoenix, AZ 85013-4425 | 2007-08-10 |
| 1952311037 | Southwestern Cardiovascular and Thoracic Surgeons Ltd | Surgery | 10390 N Tatum Blvd, Suite 103, Phoenix, AZ 85028 | 2006-08-09 |
| 1356303747 | Ronald D Gordon | Surgery | 3811 East Bell Road, Suite 208, Phoenix, AZ 85032 | 2006-04-03 |
| 1003876269 | Jeromy Brink | Surgery | 3033 N Central Ave, 610, Phoenix, AZ 85012-2809 | 2006-03-23 |
| 1275502015 | Valley Vascular Surgeons PC | Surgery | 3811 East Bell Rd, Suite 208, Phoenix, AZ 85032 | 2006-03-15 |
| 1902807852 | Dawn Marie Olsen | Surgery | 3600 N 3rd Ave Ste B, Phoenix, AZ 85013-3944 | 2005-08-02 |
| 1881698256 | Casey L Huston | Surgery | 4045 E Bell Rd, Suite 127, Phoenix, AZ 85032-2236 | 2005-06-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.