Provider Demographics
NPI:1093903387
Name:BOWDEN, CLARK (OD)
Entity Type:Individual
Prefix:DR
First Name:CLARK
Middle Name:
Last Name:BOWDEN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 DONALD LYNCH BLVD STE 2151
Mailing Address - Street 2:
Mailing Address - City:MARLBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01752-4735
Mailing Address - Country:US
Mailing Address - Phone:508-481-8279
Mailing Address - Fax:508-303-0845
Practice Address - Street 1:601 DONALD LYNCH BLVD STE 2151
Practice Address - Street 2:
Practice Address - City:MARLBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01752-4735
Practice Address - Country:US
Practice Address - Phone:508-481-8279
Practice Address - Fax:508-303-0845
Is Sole Proprietor?:No
Enumeration Date:2007-10-11
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4625152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist