MEDICARE: MRS. HOLLY E BOWIE OD

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	152W00000X	Optometrist	705	MS

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CI2398	OTHER		MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1972506020
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. HOLLY E BOWIE OD

Provider Business Mailing Address
First Line	:	3430 BIENVILLE BLVD
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-5732
Country	:	US
Telephone Number	:	228-875-6658
Fax Number	:	228-875-0809

Provider Business Practice Location Address
First Line	:	3430 BIENVILLE BLVD
Second Line	:
City	:	OCEAN SPRINGS
State	:	MS
Zip	:	39564-5732
Country	:	US
Telephone Number	:	228-875-6658
Fax Number	:	228-875-0809

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

Provider Enumeration Date	:	05/23/2005
Last Update Date	:	09/04/2008

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