Provider Demographics
NPI:1013202548
Name:BOWEN, JAMES DOWLING
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DOWLING
Last Name:BOWEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3147 CASON RD
Mailing Address - Street 2:
Mailing Address - City:BLACKSHEAR
Mailing Address - State:GA
Mailing Address - Zip Code:31516-4488
Mailing Address - Country:US
Mailing Address - Phone:912-449-4855
Mailing Address - Fax:912-449-0580
Practice Address - Street 1:3147 CASON RD
Practice Address - Street 2:
Practice Address - City:BLACKSHEAR
Practice Address - State:GA
Practice Address - Zip Code:31516-4488
Practice Address - Country:US
Practice Address - Phone:912-449-4855
Practice Address - Fax:912-449-0580
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-13
Last Update Date:2011-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057540157343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)