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Individual

JASON D. BOWERSOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
830 W HIGH ST, SUITE 360, LIMA, OH 45801
(419) 227-7117
(419) 227-2848
Mailing address
830 W HIGH ST STE 360, LIMA, OH 45801-3985
(419) 227-7117
(419) 227-2848

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
35089145
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2737417
OH
Enumeration date
04/18/2007
Last updated
05/30/2018
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