Individual
PAUL JASON BOWLDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
701 E COUNTY LINE RD, SUITE 201, GREENWOOD, IN 46143-1072
(317) 865-8000
(317) 865-8012
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
01066153A
IN
208600000X
Surgery Physician
36949
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201055670
—
IN
01
—
P01157298
RR MEDICARE PTAN
IN
Enumeration date
02/10/2006
Last updated
11/27/2023
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