G. Wilson Bowers, M.D.
Individual provider Active NPI Pediatrics Physician · Jackson, OH
NPI 1861446221 · NPPES record last updated Mar 17, 2011
Key facts
- NPI
- 1861446221
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatrics Physician 208000000X
- License
- 35-03-1628 (OH)
- Practice address
- 280 Pattonsville Rd
Jackson, OH 45640-9452 - Phone
- (740) 395-8805
- Fax
- (740) 395-8855
- NPI assigned
- May 20, 2006
- 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)
- Yes
- Credentials
- Doctor of Medicine
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 35-03-1628 | OH | Yes |
Addresses
Primary practice location
280 Pattonsville Rd
Jackson, OH 45640-9452
Mailing address
90 Jackson Pike
Gallipolis, OH 45631-1560
Phone (740) 395-8805
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0113648 | Other | OH | MOLINA MEDICAID |
| 310917085056 | Other | OH | CARESOURCE MEDICAID |
| 370002074 | Other | RR MEDICARE | |
| 0112101000 | Medicaid | WV | |
| 000000181836 | Other | OH | UNISON MEDICAID |
| 0113648 | Medicaid | OH |
Other providers in Jackson, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 17, 2011. 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.