Individual
DR. JEFFREY D. BOWMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1410 N MARKET ST, SPARTA, IL 62286-2302
(618) 443-4373
(618) 443-2682
Mailing address
1410 N MARKET ST, SPARTA, IL 62286-2302
(618) 443-4373
(618) 443-2682
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
TO3081
MO
152W00000X
Optometrist
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
269681
GROUP HEALTH PLAN
—
01
—
59572
HEALTHCARE USA
MO
01
—
MO3081
EYEMED
—
01
—
UNKNOWN
UNBTIED HEALTHCARE
—
Enumeration date
03/09/2006
Last updated
07/08/2007
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