Provider Demographics
NPI:1346318789
Name:TOWERS, BRUCE K (PAC, MPAS, BBA)
Entity Type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:K
Last Name:TOWERS
Suffix:
Gender:M
Credentials:PAC, MPAS, BBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1701 NW HAWTHORNE AVENUE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526
Mailing Address - Country:US
Mailing Address - Phone:541-471-3455
Mailing Address - Fax:541-471-1439
Practice Address - Street 1:1701 NW HAWTHORNE AVENUE
Practice Address - Street 2:SUITE 201
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526
Practice Address - Country:US
Practice Address - Phone:541-471-3455
Practice Address - Fax:541-471-1439
Is Sole Proprietor?:No
Enumeration Date:2006-12-02
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA01427363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical