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DR. GARY WAYNE BOWMAN D.O.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1558473058

Individual Registrant:
DR. GARY WAYNE BOWMAN D.O.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
55A S BROADVIEW  GREENBRIER, AR 72058 US
Tel: 501-679-4030  Fax: 501-679-4037

Contact information for business:
PO BOX 596  GREENBRIER, AR 72058 US
Tel: 501-679-4030  Fax: 501-679-4037

Registration Information:
NPI: 1558473058
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
ARR4093

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
117992003AR05
FEDERAL TAX ID710249735AR01
QUAL CHOICE ID16194000000AR01




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