Organization Active NPI

C Gregory Bowling MD a Professional Medical Corporation

Doing business as Medical Laboratory of SW LA

  • Anatomic Pathology & Clinical Pathology Physician
  • Lake Charles, LA
National Provider Identifier
1104963107
Registry record updated Sep 3, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
Legal business name
C GREGORY BOWLING MD A PROFESSIONAL MEDICAL CORPORATION
Doing business as
Medical Laboratory of SW LA
Practice address
1910 Oak Park Blvd
Lake Charles, LA 70601-8916
Phone
(337) 478-1214
Fax
(337) 478-2544
NPI assigned
Jan 30, 2007
Last updated
Sep 3, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
C. Gregory Bowling, M.D.
Title
President
Phone
(337) 478-1214

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anatomic Pathology & Clinical Pathology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207ZP0102X Primary

Addresses

Primary practice location

1910 Oak Park Blvd
Lake Charles, LA 70601-8916

Mailing address

1910 Oak Park Blvd
Lake Charles, LA 70601-8916
Phone (337) 478-1214

Other identifiers 1

IdentifierTypeStateIssuer
1946150MedicaidLA

Other names 1

  • Medical Laboratory of SW LA Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283472000000",
    "number": "1104963107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1910 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018916",
            "telephone_number": "337-478-1214",
            "fax_number": "337-478-2544"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018916",
            "telephone_number": "337-478-1214",
            "fax_number": "337-478-2544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C GREGORY BOWLING MD A PROFESSIONAL MEDICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2010-09-03",
        "status": "A",
        "authorized_official_last_name": "BOWLING",
        "authorized_official_first_name": "C.",
        "authorized_official_middle_name": "GREGORY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "337-478-1214",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1946150",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medical Laboratory of SW LA",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lake Charles, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.