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NPI Code Detail

MEDICARE: CARRIE P. BOWLING PA-C

MEDICARE: CARRIE P. BOWLING PA-C
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
1363A00000XPhysician Assistant003879GA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1720017692
Entity Type Code : Individual
Provider Name (Legal Business Name) : CARRIE P. BOWLING PA-C
Provider Business Mailing Address
First Line : 2412 N OAK ST
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-2567
Country : US
Telephone Number : 229-244-1400
Fax Number :
Provider Business Practice Location Address
First Line : 2412 N OAK ST
Second Line :
City : VALDOSTA
State : GA
Zip : 31602-2567
Country : US
Telephone Number : 229-244-1400
Fax Number : 229-244-5512
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2006
Last Update Date : 05/27/2020

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Directions to “ CARRIE P. BOWLING PA-C” Practice Location

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