Organization
BRENT J BOWEN M.D. P.C.
Active
Other names
BRENT J BOWEN, M.D.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRENT JAMES BOWEN M.D. (OWNER)
(801) 314-2362
Entity
Organization
Contact information
Practice address
5770 S 250 E STE 235, MURRAY, UT 84107-6191
(801) 314-5115
Mailing address
PO BOX 57547, SALT LAKE CITY, UT 84157-0547
(801) 314-2362
(801) 314-5117
Taxonomy
Speciality
Code
Description
License number
State
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
2736038905
UT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710152228
MEDICARE NPI
UT
01
—
1780644054
PROVIDER NPI
UT
Enumeration date
11/15/2013
Last updated
11/15/2013
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