Provider Demographics
NPI:1740249564
Name:BOWDEN, HERBERT HORTON JR (MD)
Entity type:Individual
Prefix:DR
First Name:HERBERT
Middle Name:HORTON
Last Name:BOWDEN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:BERT
Other - Middle Name:H
Other - Last Name:BOWDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:656 HONEYCOMB RD
Mailing Address - Street 2:
Mailing Address - City:GRANT
Mailing Address - State:AL
Mailing Address - Zip Code:35747-9378
Mailing Address - Country:US
Mailing Address - Phone:256-539-9937
Mailing Address - Fax:256-539-3333
Practice Address - Street 1:7500 MEMORIAL PKWY SW STE 118
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2227
Practice Address - Country:US
Practice Address - Phone:256-539-9937
Practice Address - Fax:256-539-3333
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-21
Last Update Date:2021-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000196202086S0122X, 207W00000X
TXF6464207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL2400065550OtherRAILROAD MEDICARE NO.
AL000026246Medicaid
AL051009438OtherBCBS OF AL PROVIDER NO
ALA37364Medicare UPIN
AL051009438OtherBCBS OF AL PROVIDER NO