Provider Demographics
NPI:1750460374
Name:BOWIE, CHARLES HAROLD (MD)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:HAROLD
Last Name:BOWIE
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:PO BOX 1660
Mailing Address - Street 2:
Mailing Address - City:EUNICE
Mailing Address - State:LA
Mailing Address - Zip Code:70535-1660
Mailing Address - Country:US
Mailing Address - Phone:337-457-8916
Mailing Address - Fax:337-457-8921
Practice Address - Street 1:1221 E LAUREL AVE
Practice Address - Street 2:
Practice Address - City:EUNICE
Practice Address - State:LA
Practice Address - Zip Code:70535-3705
Practice Address - Country:US
Practice Address - Phone:337-457-8916
Practice Address - Fax:337-457-8921
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2020-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA016575208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1357634Medicaid
LA35353OtherBLUE CROSS
LA5M960Medicare ID - Type Unspecified
LA1357634Medicaid