Provider Demographics
NPI:1952458572
Name:BOWMAN, CHALMER HADLEY (DPH)
Entity Type:Individual
Prefix:DR
First Name:CHALMER
Middle Name:HADLEY
Last Name:BOWMAN
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6736 NW 39TH EXPY
Mailing Address - Street 2:
Mailing Address - City:BETHANY
Mailing Address - State:OK
Mailing Address - Zip Code:73008-2647
Mailing Address - Country:US
Mailing Address - Phone:405-789-2126
Mailing Address - Fax:405-603-7496
Practice Address - Street 1:6736 NW 39TH EXPY
Practice Address - Street 2:
Practice Address - City:BETHANY
Practice Address - State:OK
Practice Address - Zip Code:73008-2647
Practice Address - Country:US
Practice Address - Phone:405-789-2126
Practice Address - Fax:405-603-7496
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9241183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK9241OtherSTATE PHARMACY LICENSE