Healthcare Provider Details

I. General information

NPI: 1396711792
Provider Name (Legal Business Name): FRANK BOWYER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/24/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 PINE ST STE 360
MACON GA
31201-2173
US

IV. Provider business mailing address

598 3RD ST
MACON GA
31201-3357
US

V. Phone/Fax

Practice location:
  • Phone: 478-633-8391
  • Fax: 478-633-8395
Mailing address:
  • Phone: 478-633-6706
  • Fax: 478-633-5384

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0205X
TaxonomyPediatric Endocrinology Physician
License Number016315
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: