NPI age
18 years
Enumerated 2007-08-05
● Active
Type 1 · Individual
DR. Justin Fowler, MD
Fowler is 1 of 8 surgery providers in Boise and 1 of 11 in Idaho.
Primary specialty
Surgery
Plus 5 subspecialties
Licensed in
ID, NM, MO, TX
4 states
Status
Active
No deactivations on record
Last NPPES update
2024-12-16
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org
How this provider compares
Across 11 active surgery providers in Idaho.
NPI age
18 years
≈ at median (18 yr)
State licenses
4 states
Top 0% — 100% of peers are multi-state
Subspecialties
2
In the 100% of peers with subspecialties
NPI lifetime · 2007 → 2026
2007-08Enumerated in NPPES
2007
2026
Where they practice
Practice location
6165 W Emerald St
Boise, ID 837048613
Mailing address
3551 Roger Brooke Dr
Fort Sam Houston, TX 782344504
Additional practice locations
5 secondary locations on file with NPPES.
Location 2
5005 N Piedras St
El Paso, TX 799205001
Location 3
2606 Hospital Blvd Ste E
Corpus Christi, TX 78405
Location 4
613 Elizabeth St Ste 804
Corpus Christi, TX 784042231
Location 5
3551 Roger Brooke Dr
Fort Sam Houston, TX 782344504
Location 6
6565 E Carondelet Dr Ste 235
Tucson, AZ 857103533
Specialties
-
Surgery PrimaryA 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...
-
Military Health Care ProviderActive duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
-
Orthopaedic SurgeryRecognized by several state medical boards as a fellowship subspecialty program of orthopaedic surgery, orthopaedic trauma surgeons deal with the evaluation and management of acute orthopaedic injuries, evaluation and treatment of...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 01 (MO) | 2016027259 | MO LICENSE |
| 01 (TX) | 1L5640 | MEDICARE |
| 01 (TX) | P02601779 | MCRR |
| 05 (TX) | 390382503 |
Multi-state credentialing: Licensed in 4 states. Useful context for credentialers building cross-state provider networks.
Practice context
Part of a multi-provider practice. 17 other active providers share this practice address in NPPES.
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