Individual
G. WILSON BOWERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
280 PATTONSVILLE RD, JACKSON, OH 45640-9452
(740) 395-8805
(740) 395-8855
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 395-8805
(740) 395-8855
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35-03-1628
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000181836
UNISON MEDICAID
OH
05
—
0112101000
—
WV
01
—
0113648
MOLINA MEDICAID
OH
05
—
0113648
—
OH
01
—
310917085056
CARESOURCE MEDICAID
OH
01
—
370002074
RR MEDICARE
—
Enumeration date
05/20/2006
Last updated
03/17/2011
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