Healthcare Provider Details

I. General information

NPI: 1750523007
Provider Name (Legal Business Name): WILLIAM HERBERT BOWERS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/01/2009
Last Update Date: 08/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4320 DIPLOMACY DR SUITE 2800
ANCHORAGE AK
99508-5925
US

IV. Provider business mailing address

4320 DIPLOMACY DR SUITE 2800
ANCHORAGE AK
99508-5925
US

V. Phone/Fax

Practice location:
  • Phone: 907-563-2662
  • Fax: 907-729-2082
Mailing address:
  • Phone: 907-563-2662
  • Fax: 907-729-2082

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number1075
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: