| Bowman Family Medicine Clinic, Llc | |
|
1007 Gould Drive, Building 3, Suite 4 Bossier City LA 71111 | |
| (318) 584-7319 | |
| (318) 584-7322 |
| Full Name | Bowman Family Medicine Clinic, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 1007 Gould Drive, Building 3, Suite 4, Bossier City, Louisiana |
| Authorized Official Name and Position | Corine Hardman Bowman (SOLE OWNER) |
| Authorized Official Contact | 3184648073 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bowman Family Medicine Clinic, Llc Po Box 52364 Shreveport LA 71135-2364 Ph: (318) 798-4539 | Bowman Family Medicine Clinic, Llc 1007 Gould Drive, Building 3, Suite 4 Bossier City LA 71111 Ph: (318) 584-7319 |
| NPI Number | 1710425574 |
|---|---|
| Provider Enumeration Date | 02/01/2017 |
| Last Update Date | 04/05/2017 |
| Medicare PECOS PAC ID | 6305121104 |
|---|---|
| Medicare Enrollment ID | O20170317000818 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710425574 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 023946 (Louisiana) | Primary |
| Provider Name | Corine Bowman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841241007 PECOS PAC ID: 8325026818 Enrollment ID: I20040712000220 |
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