Provider Demographics
NPI:1801856810
Name:BOWLES, BARRY VINCENT (OD)
Entity Type:Individual
Prefix:DR
First Name:BARRY
Middle Name:VINCENT
Last Name:BOWLES
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:211 S PLATTE CLAY WAY
Mailing Address - Street 2:SUITE A
Mailing Address - City:KEARNEY
Mailing Address - State:MO
Mailing Address - Zip Code:64060-7592
Mailing Address - Country:US
Mailing Address - Phone:816-628-4401
Mailing Address - Fax:816-628-3392
Practice Address - Street 1:211 S PLATTE CLAY WAY
Practice Address - Street 2:SUITE A
Practice Address - City:KEARNEY
Practice Address - State:MO
Practice Address - Zip Code:64060-7592
Practice Address - Country:US
Practice Address - Phone:816-628-4401
Practice Address - Fax:816-628-3392
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2022-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOT02604152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO312204407Medicaid
MO312204407Medicaid
MOS160814Medicare PIN
MOT42539Medicare UPIN
MOP00182609Medicare PIN