Provider Demographics
NPI:1245233162
Name:ROWLAND, BRUCE JAMES (DO)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:JAMES
Last Name:ROWLAND
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 HOLIDAY LANE,
Mailing Address - Street 2:STE 400
Mailing Address - City:FULTON
Mailing Address - State:KY
Mailing Address - Zip Code:42041
Mailing Address - Country:US
Mailing Address - Phone:270-472-8399
Mailing Address - Fax:270-472-8398
Practice Address - Street 1:2002 HOLIDAY LANE
Practice Address - Street 2:STE 400
Practice Address - City:FULTON
Practice Address - State:KY
Practice Address - Zip Code:42041
Practice Address - Country:US
Practice Address - Phone:270-472-8399
Practice Address - Fax:270-472-8398
Is Sole Proprietor?:No
Enumeration Date:2005-05-24
Last Update Date:2009-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY02178207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY64021785Medicaid
KY000000612885OtherKY BCBS
KY000000612885OtherKY BCBS
KYC76195Medicare UPIN
KY1456401Medicare PIN