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Individual

MARK A BOWERS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2554 HIGHWAY 394, BLOUNTVILLE, TN 37617
(423) 323-3799
(423) 323-3752
Mailing address
1323 HIGHWAY 394 STE B, BLOUNTVILLE, TN 37617-4133
(423) 323-3799
(423) 323-3752

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T2336
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3945417
TN
01
4087308
BLUE CROSS BLUE SHIELD
TN
01
800110477
CIGNA
TN
Enumeration date
10/06/2006
Last updated
08/30/2021
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