Michael Gene Bowman, LPE
Individual provider Active NPI Clinical Psychologist · Talbott, TN
NPI 1770575789 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1770575789
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Psychologist 103TC0700X
- License
- PE1422 (TN)
- Practice address
- 6350 W Andrew Johnson Hwy
Talbott, TN 37877-8605 - Phone
- (423) 587-7337
- Fax
- (423) 586-0614
- NPI assigned
- Aug 16, 2005
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PE1422 | TN | MD | Clinical Psychologist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PE1422 | TN | Yes |
Addresses
Primary practice location
6350 W Andrew Johnson Hwy
Talbott, TN 37877-8605
Mailing address
Department 888182
Knoxville, TN 37995-0001
Phone (800) 355-3565
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5441317 | Medicaid | TN |
Other providers in Talbott, TN
- Kristi Michelle Black
- Michelle Lynn Blanken
- Carolyn Anne Blondin
- Caitlyn Blosser
- Tiffiney Bolton
- Karen Breeding
- Fallon Nicole Buchanan
- Amanada Rae Campbell
- Joanna Cardenas Carpanta
- Judy Ann Carpenter
All providers in Talbott, TN · Clinical Psychologist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 9, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.