MEDICARE: KAREN L BOWLWARE MD

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
1	208000000X	Pediatrics Physician	20829	OK
2	2080P0208X	Pediatric Infectious Diseases Physician	20829	OK

General Provider Information

NPI Number	:	1881662419
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAREN L BOWLWARE MD

Provider Business Mailing Address
First Line	:	1122 NE 13TH ST
Second Line	:	ORI236
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73117-1039
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1200 N PHILLIPS AVE
Second Line	:	SUITE 6100
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73104-4600
Country	:	US
Telephone Number	:	405-271-6827
Fax Number	:	405-271-4418

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	04/04/2011

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Directions to “ KAREN L BOWLWARE MD” Practice Location

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