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General NPI Number Information
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NPI Number | 1861938433
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Entity Type | Organization
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Legal Business Name | SCOTT EDWARD BOWLIN
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Dates
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Enumeration Date | 01/06/2017
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Last Update Date | 01/06/2017
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Provider Practice Location Address
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Address Line | 1515 W WHITE OAK ST
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City | INDEPENDENCE
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State | MO
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Zip | 64050-2557
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Country | US
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Telephone | 816-321-2543
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Fax | 816-873-1121
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Provider Business Mailing Address
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Address Line | 5440 CLARE RD
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City | SHAWNEE
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State | KS
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Zip | 66226-2811
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Country | US
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Telephone | 816-321-2543
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Fax | 816-873-1121
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Authorized Official
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Title or Position | OWNER
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Name | SCOTT BOWLIN
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Credential | DO
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Telephone | 816-321-2543
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | R5P18
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License Number State | MO
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