Provider Demographics
NPI:1447390315
Name:BOWLER, MORGAN P (PA-C)
Entity Type:Individual
Prefix:MISS
First Name:MORGAN
Middle Name:P
Last Name:BOWLER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:DR
Other - First Name:MIKAELA
Other - Middle Name:MARIE
Other - Last Name:OLIVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:1100 JOHNSON FERRY RD
Mailing Address - Street 2:STE 510
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1743
Mailing Address - Country:US
Mailing Address - Phone:770-507-0029
Mailing Address - Fax:678-581-7170
Practice Address - Street 1:460 NORTHSIDE CHEROKEE BLVD STE 450
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30115-8020
Practice Address - Country:US
Practice Address - Phone:770-721-3200
Practice Address - Fax:770-721-1890
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004976363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA500839855AMedicaid
GA500839855BMedicaid
GA500839855CMedicaid
GA500839855BMedicaid
GA97WCJKFMedicare PIN