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Dr. Justin Fowler, MD
Surgical Critical Care Physician in Boise, Idaho
NPI 1386835585

Justin Fowler is a Surgical Critical Care Physician based in Fort Sam Houston, ID and is specialized in Surgical Critical Care. Justin Fowler practices in Boise, ID and has the professional credentials of MD. The NPI Number for Justin Fowler is 1386835585 and holds a License No. (Idaho).

The current practice location address for Justin Fowler is 6165 W Emerald St, Boise, ID and can be reached out via phone at 208-302-3900 and via fax at 208-302-3955.

Location: 6165 W Emerald St, Boise, ID, 78234-4504
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1386835585
Provider Name
Justin Fowler
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
6165 W Emerald St, Boise, ID, 78234-4504
Phone Number
208-302-3900
Fax Number
208-302-3955
Provider Enumeration Date
08/05/2007
Last Update Date
10/19/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1L5640 01 TX MEDICARE
P02601779 01 TX MCRR
390382503 05 TX
2016027259 01 MO MO LICENSE
institution
Provider Business Practice Location Address Details
Address
6165 W Emerald St
City
Boise
State
Idaho
Zip
83704-8613
Phone Number
208-302-3900
Fax Number
208-302-3955
person
Provider Business Mailing Address Details
Address
6165 W Emerald St
City
Boise
State
Idaho
Zip
83704-8613
Phone Number
208-302-3900
Fax Number
208-302-3955
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
MD2014-0304 (New Mexico)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
person
Provider's Taxonomy Details 2
Type
Allopathic & Osteopathic Physicians
Classification
Orthopedic Surgery
Speciality
Orthopedic Trauma
Taxonomy
207XX0801X
License No.
Q6009 (Texas)
Definition
Recognized by several state medical boards as a fellowship subspecialty program of orthopedic surgery, orthopedic trauma surgeons deal with the evaluation and management of acute orthopedic injuries, evaluation and treatment of post-traumatic deformities and nonunions, acute and delayed reconstruction of pelvic and acetabular fractures, as well as osteotomy in the adult hip for treatment of hip arthritis.
person
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
Surgery
Speciality
Surgical Critical Care
Taxonomy
2086S0102X
License No.
()
Definition
A surgeon with expertise in the management of the critically ill and postoperative patient, particularly the trauma victim, who specializes in critical care medicine diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists.
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