Provider Demographics
NPI:1164667820
Name:BOWEN, ARTHUR L (CFA/LPN)
Entity Type:Individual
Prefix:MR
First Name:ARTHUR
Middle Name:L
Last Name:BOWEN
Suffix:
Gender:M
Credentials:CFA/LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10605 S LAWRENCE ST
Mailing Address - Street 2:
Mailing Address - City:SAPULPA
Mailing Address - State:OK
Mailing Address - Zip Code:74066-1828
Mailing Address - Country:US
Mailing Address - Phone:918-812-7447
Mailing Address - Fax:918-296-9491
Practice Address - Street 1:10605 S LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:SAPULPA
Practice Address - State:OK
Practice Address - Zip Code:74066-1828
Practice Address - Country:US
Practice Address - Phone:918-812-7447
Practice Address - Fax:918-296-9491
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-10
Last Update Date:2008-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKL 0053790164W00000X
OK111647246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant
No164W00000XNursing Service ProvidersLicensed Practical Nurse