Healthcare Provider Details

I. General information

NPI: 1447682786
Provider Name (Legal Business Name): THOMAS ANDREW BOWERS NP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/08/2013
Last Update Date: 06/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 PRINCE AVE
ATHENS GA
30606
US

IV. Provider business mailing address

2727 PACES FERRY RD SE STE 1-1100
ATLANTA GA
30339-6151
US

V. Phone/Fax

Practice location:
  • Phone: 706-475-7000
  • Fax:
Mailing address:
  • Phone: 706-475-7000
  • Fax: 706-475-6676

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN178996
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: