Provider Demographics
NPI:1760878771
Name:BOWEN, COURTNEY BLYTHE (MD)
Entity Type:Individual
Prefix:MRS
First Name:COURTNEY
Middle Name:BLYTHE
Last Name:BOWEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:BLYTHE
Other - Last Name:BOWEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1120 S JACKSON HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:SHEFFIELD
Mailing Address - State:AL
Mailing Address - Zip Code:35660-5773
Mailing Address - Country:US
Mailing Address - Phone:256-383-4447
Mailing Address - Fax:256-381-7999
Practice Address - Street 1:1120 S JACKSON HWY STE 300
Practice Address - Street 2:
Practice Address - City:SHEFFIELD
Practice Address - State:AL
Practice Address - Zip Code:35660-5773
Practice Address - Country:US
Practice Address - Phone:256-383-4447
Practice Address - Fax:256-381-7999
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2018-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL35732207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine