Individual
DR. GARY WAYNE BOWMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
55A S BROADVIEW, GREENBRIER, AR 72058
(501) 679-4030
(501) 679-4037
Mailing address
PO BOX 596, GREENBRIER, AR 72058
(501) 679-4030
(501) 679-4037
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
R4093
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
117992003
—
AR
01
—
16194000000
QUAL CHOICE ID
AR
01
—
710249735
FEDERAL TAX ID
AR
Enumeration date
08/31/2006
Last updated
11/01/2012
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