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NPI Code Detail

MEDICARE: C. GREGORY BOWLING, M.D., APMC

MEDICARE: C. GREGORY BOWLING, M.D., APMC
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
1291U00000XClinical Medical Laboratory

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 : 1629115365
Entity Type Code : Organization
Provider Name (Legal Business Name) : C. GREGORY BOWLING, M.D., APMC
Provider Business Mailing Address
First Line : 630 W PRIEN LAKE RD
Second Line : SUITE B NO. 294
City : LAKE CHARLES
State : LA
Zip : 70601-0700
Country : US
Telephone Number : 337-564-6726
Fax Number : 337-474-8116
Provider Business Practice Location Address
First Line : 2739 MAGNOLIA LN
Second Line :
City : LAKE CHARLES
State : LA
Zip : 70605-1011
Country : US
Telephone Number : 337-564-6726
Fax Number : 337-474-8116
Authorized Official
Title or Position : PRESIDENT
Name : C. GREGORY BOWLING
Credential : M.D.
Telephone Number : 337-564-6726
Provider Enumeration Date : 01/31/2007
Last Update Date : 04/26/2015

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