Provider Demographics
NPI:1467454371
Name:BOWSER, THOMAS E (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:E
Last Name:BOWSER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4105 BRIARGATE PKWY STE 105
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80920-3482
Mailing Address - Country:US
Mailing Address - Phone:719-637-8444
Mailing Address - Fax:719-638-8286
Practice Address - Street 1:4105 BRIARGATE PKWY STE 105
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80920-3482
Practice Address - Country:US
Practice Address - Phone:719-637-8444
Practice Address - Fax:719-638-8286
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO419072084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO93252081Medicaid
COD95093Medicare UPIN
COC806285Medicare PIN