Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 016315 | GA |
NPI | 1396711792 |
---|---|
Provider Name | Frank Bowyer |
First Address | Macon, GA 31201-3357 |
Second Address | Macon, GA 31201-2173 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000078262F | (05) | GA |
C61286 | (02) | GA |