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General NPI Number Information
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NPI Number | 1861673808
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Entity Type | Individual
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Provider Name | EMMETT W BOWERS M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/19/2007
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Last Update Date | 05/24/2011
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Provider Practice Location Address
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Address Line | 2501 N PATTERSON ST SGMC
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City | VALDOSTA
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State | GA
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Zip | 31602-1735
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Country | US
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Telephone | 229-244-6852
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Fax | 229-242-2385
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Provider Business Mailing Address
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Address Line | 2310 N PATTERSON ST SUITE C
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City | VALDOSTA
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State | GA
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Zip | 31602-2568
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Country | US
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Telephone | 229-244-6852
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Fax | 229-242-2385
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 65641
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License Number State | GA
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