Healthcare Provider Details

I. General information

NPI: 1629306592
Provider Name (Legal Business Name): F. J. BOWERS, M.D., SURGICAL PS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2009
Last Update Date: 12/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 GOETHALS DR STE 210
RICHLAND WA
99352-3552
US

IV. Provider business mailing address

945 GOETHALS DR STE 210
RICHLAND WA
99352-3552
US

V. Phone/Fax

Practice location:
  • Phone: 509-946-5512
  • Fax: 509-946-5412
Mailing address:
  • Phone: 509-946-5512
  • Fax: 509-946-5412

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2086X0206X
TaxonomySurgical Oncology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208C00000X
TaxonomyColon & Rectal Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. FREDRICK JOSEPH BOWERS
Title or Position: PHYSICIAN
Credential: MD
Phone: 509-946-5512