Provider Demographics
NPI:1154494268
Name:BOWEN, WILLIAM DOUGLAS (RPH)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DOUGLAS
Last Name:BOWEN
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1875 MONROE ST
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53711-2024
Mailing Address - Country:US
Mailing Address - Phone:608-256-8712
Mailing Address - Fax:608-256-3027
Practice Address - Street 1:1875 MONROE ST
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-2024
Practice Address - Country:US
Practice Address - Phone:608-256-8712
Practice Address - Fax:608-256-3027
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-16
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12994-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI12994-040OtherPHARMACIST