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General NPI Number Information
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NPI Number | 1356438915
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Entity Type | Individual
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Provider Name | MARK A BOWERS
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Gender | Male
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Dates
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Enumeration Date | 10/06/2006
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Last Update Date | 08/30/2021
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Provider Practice Location Address
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Address Line | 2554 HIGHWAY 394
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City | BLOUNTVILLE
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State | TN
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Zip | 37617
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Country | US
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Telephone | 423-323-3799
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Fax | 423-323-3752
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Provider Business Mailing Address
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Address Line | 1323 HIGHWAY 394 STE B
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City | BLOUNTVILLE
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State | TN
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Zip | 37617-4133
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Country | US
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Telephone | 423-323-3799
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Fax | 423-323-3752
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | T2336
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License Number State | TN
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