Provider Demographics
NPI:1033483367
Name:WILLIAM W. BOWEN MD INC
Entity Type:Organization
Organization Name:WILLIAM W. BOWEN MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:707-459-6855
Mailing Address - Street 1:84 MADRONE ST
Mailing Address - Street 2:
Mailing Address - City:WILLITS
Mailing Address - State:CA
Mailing Address - Zip Code:95490-4249
Mailing Address - Country:US
Mailing Address - Phone:707-459-6855
Mailing Address - Fax:707-459-9585
Practice Address - Street 1:84 MADRONE ST
Practice Address - Street 2:
Practice Address - City:WILLITS
Practice Address - State:CA
Practice Address - Zip Code:95490-4249
Practice Address - Country:US
Practice Address - Phone:707-459-6855
Practice Address - Fax:707-459-9585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-05
Last Update Date:2012-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG28722207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
00G287220Medicare PIN