Provider Demographics
NPI:1063493799
Name:BOWERS, JAMES L (DO)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:BOWERS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1415 E SCOTT ST
Mailing Address - Street 2:
Mailing Address - City:KIRKSVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:63501-3868
Mailing Address - Country:US
Mailing Address - Phone:660-665-1767
Mailing Address - Fax:660-665-1767
Practice Address - Street 1:1415 E SCOTT ST
Practice Address - Street 2:
Practice Address - City:KIRKSVILLE
Practice Address - State:MO
Practice Address - Zip Code:63501-3868
Practice Address - Country:US
Practice Address - Phone:660-665-1767
Practice Address - Fax:660-665-1767
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-09
Last Update Date:2023-03-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR8552207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO3978OtherBNDD
MOAB8208983OtherDEA
MOA12808Medicare UPIN