Mark T Bowen Inc Apc

Primary specialty

OptometristTaxonomy code 152W00000X

License

932-143T Issued in LA

Legal business name

MARK T BOWEN INC APC

Practice address

3190 North 1St St
Jena, LA 71342

Phone

(318) 992-6103

Fax

(318) 992-6106

NPI assigned

Oct 18, 2010

Last updated

Oct 18, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mark T Bowen, D.O.

Title

Owner

Phone

(318) 992-6103

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1287360000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1287360000000",
    "number": "1235449737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1410",
            "city": "JENA",
            "state": "LA",
            "postal_code": "713421410",
            "telephone_number": "318-992-6103",
            "fax_number": "318-992-6106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3190 NORTH 1ST ST",
            "city": "JENA",
            "state": "LA",
            "postal_code": "71342",
            "telephone_number": "318-992-6103",
            "fax_number": "318-992-6106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK T BOWEN INC APC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-10-18",
        "last_updated": "2010-10-18",
        "status": "A",
        "authorized_official_last_name": "BOWEN",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-992-6103",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Optometrist",
            "state": "LA",
            "license": "932-143T",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1370886",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Optometrist in Jena, LA
• Providers in Jena, LA by specialty
• Optometrist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.