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GARRY BLAKE BOWDEN M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1972649192

Individual Registrant:
 GARRY BLAKE BOWDEN M.D.
Gender: M
Not Sole Proprietor

Location and contact information for practice:
2300 W PARK PLACE BLVD 122 STONE MOUNTAIN, GA 30087-6713 US
Tel: 770-469-2208  Fax: 770-469-1558

Contact information for business:
PO BOX 769609  ROSWELL, GA 30076-8224 US
Tel: 770-469-2208  Fax: 770-469-1558

Registration Information:
NPI: 1972649192
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
GA034545

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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