IndividualActive
Cody Fowler, P.A.-C
NPI 1386018950 · Surgical Physician Assistant · Idaho Falls, ID
Provider details
- NPI number
- 1386018950
- Entity type
- Individual
- Primary specialty
- Surgical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- P.A.-C
- Sex
- Male
- Sole proprietor
- No
- License
- PA-1326 (ID)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3345 Potomac Way
Idaho Falls, ID 83404-4978
Phone: (208) 552-7572
Fax: (208) 552-7312
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 277381
Atlanta, GA 30384-7381
Registry dates
- Enumerated
- 2015-11-19
- Last updated
- 2022-02-08
- Certified
- 2020-12-04
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.