Individual
CARL GREGORY BOWLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 OAK PARK BLVD, LAKE CHARLES, LA 70601-8911
(337) 494-3190
(337) 494-2464
Mailing address
PO BOX 731280, DALLAS, TX 75373-1280
(318) 841-9526
(318) 841-9551
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD.06567R
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10981622
CAQH ID#
LA
05
—
1676918
—
LA
01
—
P01491733
RR MEDICARE
LA
Enumeration date
01/30/2007
Last updated
07/22/2016
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