Provider Demographics
NPI:1720065204
Name:BOWDEN, LYNDEN PREWL III (MD)
Entity Type:Individual
Prefix:
First Name:LYNDEN
Middle Name:PREWL
Last Name:BOWDEN
Suffix:III
Gender:M
Credentials:MD
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Mailing Address - Street 1:2817 REILLY ROAD MCXC-COD CREDENTIALS
Mailing Address - Street 2:WOMACK ARMY MEDICAL CENTER
Mailing Address - City:FORT BRAGG
Mailing Address - State:NC
Mailing Address - Zip Code:28310
Mailing Address - Country:US
Mailing Address - Phone:901-907-8922
Mailing Address - Fax:910-907-6069
Practice Address - Street 1:96 CIVIL AFFAIRS BATTALION
Practice Address - Street 2:BLDG H2443 SUN TYA RD
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-0001
Practice Address - Country:US
Practice Address - Phone:910-432-5730
Practice Address - Fax:910-432-5730
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-27
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
KS4292902083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine