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General NPI Number Information
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NPI Number | 1619503596
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Entity Type | Individual
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Provider Name | TY ALEXANDER BOWMAN MD
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Gender | Male
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Dates
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Enumeration Date | 03/23/2020
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Last Update Date | 04/26/2024
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Provider Practice Location Address
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Address Line | 13657 W MCDOWELL RD
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City | GOODYEAR
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State | AZ
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Zip | 85395-2601
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Country | US
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Telephone | 623-882-1640
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2132
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City | LITCHFIELD PARK
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State | AZ
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Zip | 85340-2132
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Country | US
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Telephone |
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 67421
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License Number State | AZ
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