Individual
DR. ERNEST LEE BOWLING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2625 N HIGHWAY 27, LA FAYETTE, GA 30728-6975
(256) 295-2632
Mailing address
PO BOX 764, LEESBURG, AL 35983-0764
(256) 295-2632
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
OPT001312
GA
152W00000X
Optometrist
Primary
S-703-TA-360
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00508098A
—
GA
05
—
00508098B
—
GA
05
—
009933318
—
AL
01
—
01924
BCBS PLAN #601
AL
05
—
117305
—
AL
01
—
1387502
UMWA
AL
01
—
51002339
MEDICARE TRAVELERS
AL
01
—
51103554
BCBS
AL
01
—
U05596
VIVA HEALTH
AL
Enumeration date
07/31/2006
Last updated
04/08/2011
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