Provider Demographics
NPI:1679177182
Name:BOWIE, JAMIE WRIGHT
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:WRIGHT
Last Name:BOWIE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 RUSSELL PKWY
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-6058
Mailing Address - Country:US
Mailing Address - Phone:478-922-4458
Mailing Address - Fax:478-329-8740
Practice Address - Street 1:805 RUSSELL PKWY
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-6058
Practice Address - Country:US
Practice Address - Phone:478-922-4458
Practice Address - Fax:478-329-8740
Is Sole Proprietor?:No
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH022359183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist