Provider Demographics
NPI:1346552999
Name:BOWLING, JOSEPH RAY (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:RAY
Last Name:BOWLING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 S VINSON BLVD
Mailing Address - Street 2:
Mailing Address - City:LOUISA
Mailing Address - State:KY
Mailing Address - Zip Code:41230
Mailing Address - Country:US
Mailing Address - Phone:606-638-4731
Mailing Address - Fax:
Practice Address - Street 1:112 S VINSON BLVD
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41169
Practice Address - Country:US
Practice Address - Phone:606-638-4731
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-12
Last Update Date:2014-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY1803DT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist