Provider Demographics
NPI:1770527079
Name:RON BOWMAN MD PC
Entity type:Organization
Organization Name:RON BOWMAN MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RON
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-352-1313
Mailing Address - Street 1:9445 SW LOCUST ST
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6634
Mailing Address - Country:US
Mailing Address - Phone:503-352-1313
Mailing Address - Fax:503-352-1314
Practice Address - Street 1:9445 SW LOCUST ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6634
Practice Address - Country:US
Practice Address - Phone:503-352-1313
Practice Address - Fax:503-352-1314
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORP00296983OtherRAILROAD MEDICARE
OR1770527079OtherNPI NUMBER
OR133083Medicare PIN