Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | 26244 | AZ |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 26244 | AZ |
NPI | 1134120728 |
---|---|
Provider Name | Kevin W Bowers |
First Address | Tucson, AZ 85751-1630 |
Second Address | Oro Valley, AZ 85755-5819 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2005 |
Last Update Date | 02/08/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
428046 | (05) | AZ |
G69089 | (02) | AZ |