MEDICARE: BETTY BOWERS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207L00000X	Anesthesiology Physician	13078	OK
2	207QA0505X	Adult Medicine Physician	13078	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1952385908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETTY BOWERS M.D.

Provider Business Mailing Address
First Line	:	14024 QUAIL POINTE DR
Second Line	:	ATTN: CREDENTIALING
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73134-1006
Country	:	US
Telephone Number	:	405-419-8420
Fax Number	:	405-419-7902

Provider Business Practice Location Address
First Line	:	1000 N LINCOLN BLVD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-3252
Country	:	US
Telephone Number	:	405-272-9644
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/02/2005
Last Update Date	:	05/22/2012

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