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Individual

DR. PAUL KENDELL BOWERS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP-C, D.C.

Contact information

Practice address
1133 CALL PL STE A, POCATELLO, ID 83201-3076
(208) 232-1000
(208) 232-1006
Mailing address
PO BOX 4868, POCATELLO, ID 83205-4868
(208) 232-1000
(208) 232-1006

Taxonomy

Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
CHIA-901
ID
363LF0000X
Family Nurse Practitioner
Primary
NP-1325A
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010027899
REGENCE BLUE SHIELD OF ID
ID
01
350052262
RAILROAD MEDICARE
ID
05
805681800
ID
01
820530992
TAX ID # FOR OTHER INS.
ID
01
C1658
BLUE CROSS OF IDAHO
ID
Enumeration date
06/04/2006
Last updated
09/03/2021
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