Ricky D Bowlin, MD LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

35066556 Issued in OH

Legal business name

RICKY D BOWLIN, MD LLC

Practice address

130 West Martz Street
Suite 3
Greenville, OH 45331

Phone

(937) 548-5114

NPI assigned

Apr 18, 2007

Last updated

Jun 28, 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

Ricky D Bowlin, MD

Title

Owner

Phone

(937) 548-5114

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1176854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277683200000",
    "number": "1902023559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 WEST MARTZ STREET",
            "address_2": "SUITE 3",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "45331",
            "telephone_number": "937-548-5114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 WEST MARTZ STREET",
            "address_2": "SUITE 3",
            "city": "GREENVILLE",
            "state": "OH",
            "postal_code": "45331",
            "telephone_number": "937-548-5114"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICKY D BOWLIN, MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-18",
        "last_updated": "2010-06-28",
        "status": "A",
        "authorized_official_last_name": "BOWLIN",
        "authorized_official_first_name": "RICKY",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "937-548-5114",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35066556",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2208211",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Internal Medicine Physician in Greenville, OH
• Providers in Greenville, OH by specialty
• Internal Medicine Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 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.