Healthcare Provider Details

I. General information

NPI: 1912392408
Provider Name (Legal Business Name): MICHAEL REID BOWES D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 06/16/2026
Certification Date: 06/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

292 S 1470 E
ST GEORGE UT
84790-1763
US

IV. Provider business mailing address

PO BOX 27128
SLC UT
84127-0128
US

V. Phone/Fax

Practice location:
  • Phone: 435-251-5900
  • Fax: 435-251-5901
Mailing address:
  • Phone: 435-251-5900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number14212886-1204
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberDR.0072603
License Number StateCO
# 3
Primary TaxonomyN
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number14212886-1204
License Number StateUT
# 4
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number14212886-1204
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: