Provider Demographics
NPI:1205873544
Name:DONN E BOWERS MD APMC
Entity type:Organization
Organization Name:DONN E BOWERS MD APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DONN
Authorized Official - Middle Name:E
Authorized Official - Last Name:BOWERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:228-867-4499
Mailing Address - Street 1:PO BOX 16745
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39404-6745
Mailing Address - Country:US
Mailing Address - Phone:228-867-4499
Mailing Address - Fax:228-867-5027
Practice Address - Street 1:4500 13TH ST
Practice Address - Street 2:WOUND CARE DEPT/MEMORIAL HOSPITAL
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2515
Practice Address - Country:US
Practice Address - Phone:228-867-4499
Practice Address - Fax:228-867-5027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2083P0011XAllopathic & Osteopathic PhysiciansPreventive MedicineUndersea and Hyperbaric MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS03451502Medicaid
MS512G700207Medicare PIN