Organization
DRS. WOOD, LANIER & BOWMAN, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL TODD BOWMAN O.D. (OWNER)
(904) 280-9000
Entity
Organization
Contact information
Practice address
120 A1A N STE 101, PONTE VEDRA BEACH, FL 32082-6609
(904) 280-9000
(904) 280-4448
Mailing address
120 A1A N STE 101, PONTE VEDRA BEACH, FL 32082-6609
(904) 280-9000
(904) 280-4448
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
72844A
BLUE CROSS BLUE SHIELD
FL
01
—
CI9975
RAILROAD MEDICARE
—
Enumeration date
11/19/2007
Last updated
02/22/2008
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