Healthcare Provider Details

I. General information

NPI: 1417064551
Provider Name (Legal Business Name): TALMADGE ARTON BOWDEN JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 FREEDOM WAY
AUGUSTA GA
30904-6258
US

IV. Provider business mailing address

1 FREEDOM WAY
AUGUSTA GA
30904-6258
US

V. Phone/Fax

Practice location:
  • Phone: 706-733-0188
  • Fax: 706-823-3983
Mailing address:
  • Phone: 706-733-0188
  • Fax: 706-823-3983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number11288
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: