MR. TIMOTHY DALE JR. FOWLER (P.A.) – Physician Assistant, NPI 1073532404

MR. TIMOTHY DALE JR. FOWLER (P.A.) is a healthcare provider. based in Colquitt, Georgia. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials P.A.. They hold a License No. 003482 (GA). The NPI Number for MR. TIMOTHY DALE JR. FOWLER (P.A.) is 1073532404

Main info

Male
Sole Proprietor
26 Years Of Experience
Accepts Medicare Assignment
Name
MR. TIMOTHY DALE JR. FOWLER (P.A.)
NPI
1073532404
Phone
(229) 758-4864
Address
209 N Cuthbert St
Enumeration Date
18 July 2006
Last Update Date
2 June 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8509202065
Graduation Year
2000 (26 years ago)
PAC ID
3577595578
Group Practice PAC ID
8123559168
Professional Enrollment ID
I20171003005225
Address ID
FL324356307DE4413XSXXX500
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience62
Completeness75
Years active:19State licenses:1Digital endpointsOther names

4,430 PHYSICIAN ASSISTANT in GA

Provider Addresses for MR. TIMOTHY DALE JR. FOWLER (P.A.)

  • 209 N Cuthbert St

    Colquitt, GA 398373518

    Phone: (229) 758-4864

    Fax: (229) 758-8473

    Type: Location

  • 601 E ROLLINS ST

    ORLANDO, FL 328031248

    Phone: (407) 543-5732

    Type: Location

  • Miller County Hospital, 209, North Cuthbert Street, Colquitt, Miller County, Georgia, 39837, United States

    COLQUITT, GA 398373518

    Phone: (229) 758-4864

    Fax: (229) 758-8473

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-02-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking 4 Medicare enrollment records; no due dates published yet.

Enrollment records

4

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050909000580IPhysician AssistantGATBD
I20171003005225IPhysician AssistantFLTBD
I20230201002446IPhysician AssistantALTBD
I20240213002726IPhysician AssistantNYTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99284Emergency department visit with moderate level of medical decision making5554$0
99283Emergency department visit with low level of medical decision making1515$0
View full utilization report →

Insurance plans in this area (ZIP 39837)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8123559168View full group profile
NameSpecialtyState
Emergency MedicineFL
Emergency MedicineMO
Emergency MedicineFL
Orthopedic SurgeryFL
Emergency Medicine, Internal MedicineFL
Family Practice, Emergency MedicineLA
Family PracticeFL
Nurse PractitionerFL
Nurse PractitionerGA
Nurse PractitionerFL

Reviews

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Frequently asked questions

Can I cross-check MR. TIMOTHY DALE JR. FOWLER (P.A.) using NPI 1073532404?
NPI 1073532404 belongs to MR. TIMOTHY DALE JR. FOWLER (P.A.); compare other details if you need extra assurance.
Is there an active status for MR. TIMOTHY DALE JR. FOWLER (P.A.)?
For scheduling context, MR. TIMOTHY DALE JR. FOWLER (P.A.) is shown as active in the registry.
What clinical focus is listed for MR. TIMOTHY DALE JR. FOWLER (P.A.)?
At a glance, MR. TIMOTHY DALE JR. FOWLER (P.A.) is tied to Physician Assistant. Clinical services aligned with this taxonomy classification.
Is MR. TIMOTHY DALE JR. FOWLER (P.A.) located near Colquitt?
MR. TIMOTHY DALE JR. FOWLER (P.A.) currently maps to Colquitt, Georgia in this extract.
When was this NPI issued?
Enumeration for MR. TIMOTHY DALE JR. FOWLER (P.A.) is noted as July 18, 2006 where the registry provides it.

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