Provider Demographics
NPI:1790757540
Name:BOWES, BRIAN NELSON (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:NELSON
Last Name:BOWES
Suffix:
Gender:M
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:2640 COUNTRY CLUB BLVD
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5710
Mailing Address - Country:US
Mailing Address - Phone:904-542-7910
Mailing Address - Fax:904-542-7913
Practice Address - Street 1:2080 CHILD ST
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32214-5005
Practice Address - Country:US
Practice Address - Phone:904-542-7910
Practice Address - Fax:904-542-7913
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101102802207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine