Provider Demographics
NPI:1518057645
Name:BOWMAN, ROBERT C (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:C
Last Name:BOWMAN
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 1:3086 US HIGHWAY 41 N
Mailing Address - Street 2:
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31793-5628
Mailing Address - Country:US
Mailing Address - Phone:229-388-0266
Mailing Address - Fax:
Practice Address - Street 1:130 MOORE ST
Practice Address - Street 2:
Practice Address - City:OMEGA
Practice Address - State:GA
Practice Address - Zip Code:31775-3075
Practice Address - Country:US
Practice Address - Phone:229-528-6500
Practice Address - Fax:229-528-3283
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031387207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA930025850OtherRAILROAD RETIREMENT
GA00398582HMedicaid
GA08BDBGVMedicare ID - Type Unspecified
GA930025850OtherRAILROAD RETIREMENT