Provider Demographics
NPI:1003055948
Name:BOWLIN, CALVIN GENE (CAC)
Entity Type:Individual
Prefix:MR
First Name:CALVIN
Middle Name:GENE
Last Name:BOWLIN
Suffix:
Gender:M
Credentials:CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 TULANE AVE.
Mailing Address - Street 2:# 800
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70119
Mailing Address - Country:US
Mailing Address - Phone:504-826-2004
Mailing Address - Fax:504-826-2005
Practice Address - Street 1:2601 TULANE AVE
Practice Address - Street 2:# 800
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70119-7462
Practice Address - Country:US
Practice Address - Phone:504-826-2004
Practice Address - Fax:504-826-2005
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA1089101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)