Provider Demographics
NPI:1164812202
Name:COWANS, ALVIN (DPM)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:
Last Name:COWANS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5077 DALLAS HWY STE 311
Mailing Address - Street 2:
Mailing Address - City:POWDER SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30127-4510
Mailing Address - Country:US
Mailing Address - Phone:770-727-0614
Mailing Address - Fax:770-799-8453
Practice Address - Street 1:5077 DALLAS HWY STE 311
Practice Address - Street 2:
Practice Address - City:POWDER SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30127-4510
Practice Address - Country:US
Practice Address - Phone:770-727-0614
Practice Address - Fax:770-799-8453
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-28
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD001279213ES0103X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery