Provider Demographics
NPI:1750353819
Name:GOWING, ROY D (DC)
Entity type:Individual
Prefix:DR
First Name:ROY
Middle Name:D
Last Name:GOWING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 9TH ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-1204
Mailing Address - Country:US
Mailing Address - Phone:727-525-5500
Mailing Address - Fax:727-522-2574
Practice Address - Street 1:5500 9TH ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-1204
Practice Address - Country:US
Practice Address - Phone:727-525-5500
Practice Address - Fax:727-522-2574
Is Sole Proprietor?:No
Enumeration Date:2006-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH0003950111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL381153100Medicaid
FL88771Medicare ID - Type Unspecified
FL381153100Medicaid