Provider Demographics
NPI:1659463958
Name:BOWLES, JOAN M (MD)
Entity Type:Individual
Prefix:
First Name:JOAN
Middle Name:M
Last Name:BOWLES
Suffix:
Gender:F
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:PO BOX 24730
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37202-4730
Mailing Address - Country:US
Mailing Address - Phone:615-386-2300
Mailing Address - Fax:615-386-2399
Practice Address - Street 1:4220 HARDING RD
Practice Address - Street 2:SUITE 500
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37205-2005
Practice Address - Country:US
Practice Address - Phone:615-222-6977
Practice Address - Fax:615-222-5322
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2014-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN32019207R00000X, 207RC0000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100023060Medicaid
P00398623OtherRAILROAD MEDICARE
TN3861249Medicaid
TN4006046OtherBCBSTN
TN3861248Medicaid
TN4151456OtherBCBS
0007038612OtherAETNA
TN3710089Medicaid
TN3861249Medicare PIN
TNH38294Medicare UPIN
TN3861248Medicare ID - Type Unspecified
TN3861249Medicaid