Healthcare Provider Details

I. General information

NPI: 1477533024
Provider Name (Legal Business Name): KATHRYN DONITA BOWMAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2426 BUHNE ST
EUREKA CA
95501-3207
US

IV. Provider business mailing address

PO BOX 8369
HOT SPRINGS VILLAGE AR
71910-8369
US

V. Phone/Fax

Practice location:
  • Phone: 707-443-4666
  • Fax: 707-445-4499
Mailing address:
  • Phone: 501-624-3056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC-8317
License Number StateAR
# 2
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberC163360
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: