Provider Demographics
NPI:1457018798
Name:BOWDEN, BRADLY
Entity Type:Individual
Prefix:
First Name:BRADLY
Middle Name:
Last Name:BOWDEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 COGSWELL AVE STE 207
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35125-2727
Mailing Address - Country:US
Mailing Address - Phone:256-504-3231
Mailing Address - Fax:659-658-4081
Practice Address - Street 1:4800 COGSWELL AVE STE 207
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35125-2727
Practice Address - Country:US
Practice Address - Phone:659-658-4080
Practice Address - Fax:659-658-4081
Is Sole Proprietor?:No
Enumeration Date:2021-11-22
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy