Healthcare Provider Details

I. General information

NPI: 1073071478
Provider Name (Legal Business Name): ALEXANDRA ANNE BOWLES DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2019
Last Update Date: 10/16/2023
Certification Date: 10/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7730 MONTGOMERY RD
CINCINNATI OH
45236-4283
US

IV. Provider business mailing address

7730 MONTGOMERY RD
CINCINNATI OH
45236-4283
US

V. Phone/Fax

Practice location:
  • Phone: 513-984-4800
  • Fax: 513-984-5470
Mailing address:
  • Phone: 139-844-8005
  • Fax: 513-984-5470

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number1073071478
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number34.016375
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number17462
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: