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NPI Code Detail

MEDICARE: C GREGORY BOWLING MD A PROFESSIONAL MEDICAL CORPORATION

MEDICARE: C GREGORY BOWLING MD A PROFESSIONAL MEDICAL CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207ZP0102XAnatomic Pathology & Clinical Pathology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104963107
Entity Type Code : Organization
Provider Name (Legal Business Name) : C GREGORY BOWLING MD A PROFESSIONAL MEDICAL CORPORATION
Provider Business Mailing Address
First Line : 1910 OAK PARK BLVD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-8916
Country : US
Telephone Number : 337-478-1214
Fax Number : 337-478-2544
Provider Business Practice Location Address
First Line : 1910 OAK PARK BLVD
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70601-8916
Country : US
Telephone Number : 337-478-1214
Fax Number : 337-478-2544
Authorized Official
Title or Position : PRESIDENT
Name : C. GREGORY BOWLING
Credential : M.D.
Telephone Number : 337-478-1214
Provider Enumeration Date : 01/30/2007
Last Update Date : 09/03/2010

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