Provider Demographics
NPI:1598205627
Name:BOWLING ORTHOPAEDICS PA
Entity Type:Organization
Organization Name:BOWLING ORTHOPAEDICS PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRADSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:910-395-8333
Mailing Address - Street 1:5220 OLEANDER DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28403-7021
Mailing Address - Country:US
Mailing Address - Phone:910-395-8333
Mailing Address - Fax:910-395-8473
Practice Address - Street 1:5220 OLEANDER DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28403-7021
Practice Address - Country:US
Practice Address - Phone:910-395-8333
Practice Address - Fax:910-395-8473
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty