Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 38971 | TN |
N | 207VG0400X | Gynecologist | 38971 | TN |
NPI | 1255398004 |
---|---|
Provider Name | C Bryce Bowling |
First Address | Nashville, TN 37244-0439 |
Second Address | Knoxville, TN 37920-1510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/04/2006 |
Last Update Date | 17/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I19683 | (02) | |
Q022664 | (05) | TN |