Provider Demographics
NPI:1891088811
Name:ERNEST L. BOWLING, OD, MS, FAAO, PC
Entity Type:Organization
Organization Name:ERNEST L. BOWLING, OD, MS, FAAO, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ERNEST
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:BOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:256-295-2632
Mailing Address - Street 1:PO BOX 764
Mailing Address - Street 2:
Mailing Address - City:LEESBURG
Mailing Address - State:AL
Mailing Address - Zip Code:35983-0764
Mailing Address - Country:US
Mailing Address - Phone:256-295-2632
Mailing Address - Fax:256-543-1094
Practice Address - Street 1:1413 RAINBOW DR STE 1
Practice Address - Street 2:
Practice Address - City:GADSDEN
Practice Address - State:AL
Practice Address - Zip Code:35901-5319
Practice Address - Country:US
Practice Address - Phone:256-543-8886
Practice Address - Fax:256-546-1094
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT 001312152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty