Provider Demographics
NPI:1033487046
Name:BOWLIN, MARY ELISABETH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:ELISABETH
Last Name:BOWLIN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ELISABETH
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:105 HIGHWAY 51 N
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-2351
Mailing Address - Country:US
Mailing Address - Phone:662-563-2855
Mailing Address - Fax:662-563-2844
Practice Address - Street 1:105 HIGHWAY 51 N
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-2351
Practice Address - Country:US
Practice Address - Phone:662-563-2855
Practice Address - Fax:662-563-2844
Is Sole Proprietor?:No
Enumeration Date:2011-12-05
Last Update Date:2011-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-09439183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist