Individual
DR. KENNETH LEE BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1150 SALIDO AVE, LADY LAKE, FL 32159
(715) 610-7401
(844) 395-8871
Mailing address
1150 SALIDO AVE, LADY LAKE, FL 32159
(715) 635-0165
(844) 395-8871
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
43368-20
WI
2085B0100X
Body Imaging Physician
ME146719
FL
2085R0202X
Diagnostic Radiology Physician
Primary
43368
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34136600
—
WI
Enumeration date
12/19/2006
Last updated
10/20/2021
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