Provider Demographics
NPI:1053311068
Name:BOWMAN, VERNON DEAN JR (MD)
Entity Type:Individual
Prefix:DR
First Name:VERNON
Middle Name:DEAN
Last Name:BOWMAN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 HWY 32-2A
Mailing Address - Street 2:
Mailing Address - City:ASHDOWN
Mailing Address - State:AR
Mailing Address - Zip Code:71822
Mailing Address - Country:US
Mailing Address - Phone:870-898-5525
Mailing Address - Fax:
Practice Address - Street 1:146 HWY 32-2A
Practice Address - Street 2:
Practice Address - City:ASHDOWN
Practice Address - State:AR
Practice Address - Zip Code:71822
Practice Address - Country:US
Practice Address - Phone:870-898-5525
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-01
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXM3478207Q00000X
ARE3830207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR154230001Medicaid
AR5M935Medicare PIN
AR154230001Medicaid
TX8F5222Medicare PIN