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General NPI Number Information
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NPI Number | 1003847286
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Entity Type | Individual
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Provider Name | TONI HICKS BOWYER PA-C
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Gender | Female
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 10/31/2023
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Provider Practice Location Address
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Address Line | 98 WILLOW LN
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City | SPARTANBURG
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State | SC
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Zip | 29307-1357
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Country | US
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Telephone | 864-585-5552
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Fax | 864-597-0179
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Provider Business Mailing Address
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Address Line | DEPT. 453 PO 1000
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City | MEMPHIS
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State | TN
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Zip | 38148-0001
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Country | US
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Telephone | 828-575-2625
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Fax | 828-350-2174
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1068
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0010-00456
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 1068
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0010-00456
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License Number State | NC
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