Provider Demographics
NPI:1295700664
Name:BOWERS, JOHN T III (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:T
Last Name:BOWERS
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:850 KEMPSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502
Mailing Address - Country:US
Mailing Address - Phone:757-466-5949
Mailing Address - Fax:757-466-5834
Practice Address - Street 1:850 KEMPSVILLE RD
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23502
Practice Address - Country:US
Practice Address - Phone:757-466-5949
Practice Address - Fax:757-466-5834
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101034262207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA006026869Medicaid
B09902Medicare UPIN
VA006026869Medicaid