Provider Demographics
NPI:1669642013
Name:BOWEN, SCOT J
Entity Type:Individual
Prefix:
First Name:SCOT
Middle Name:J
Last Name:BOWEN
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:PO BOX 31581
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59107-1581
Mailing Address - Country:US
Mailing Address - Phone:406-252-3156
Mailing Address - Fax:
Practice Address - Street 1:2850 OLD HARDIN RD
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59101-6839
Practice Address - Country:US
Practice Address - Phone:406-252-3156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-01
Last Update Date:2013-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1046111N00000X
WY631111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT041283Medicaid
MTU97477Medicare UPIN