Provider Demographics
NPI:1255109039
Name:BOWERS, PAUL DAVID (RPH)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:DAVID
Last Name:BOWERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3995 DONALD ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-3946
Mailing Address - Country:US
Mailing Address - Phone:541-915-0739
Mailing Address - Fax:
Practice Address - Street 1:57 W 29TH AVE
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3242
Practice Address - Country:US
Practice Address - Phone:541-342-7648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-12
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR8101183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist