Healthcare Provider Details

I. General information

NPI: 1760111645
Provider Name (Legal Business Name): DAVID W BOWERS ANESTHESIA SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/07/2022
Last Update Date: 06/07/2022
Certification Date: 06/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1330 INTERSTATE PKWY
AUGUSTA GA
30909-5625
US

IV. Provider business mailing address

PO BOX 3967
AUGUSTA GA
30914-3967
US

V. Phone/Fax

Practice location:
  • Phone: 706-651-2020
  • Fax:
Mailing address:
  • Phone: 706-737-9250
  • Fax: 706-733-0697

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number State

VIII. Authorized Official

Name: MR. DAVID W BOWERS
Title or Position: OWNER
Credential: CRNA
Phone: 706-533-4614