Basic Information
| Provider Information | |||||||||
| NPI: | 1003102252 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | KATHRYN D BOWMAN, PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3560 N HIGHWAY 7 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719099608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016243056 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3560 N HIGHWAY 7 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719099608 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016243056 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/27/2011 | ||||||||
| LastUpdateDate: | 06/30/2011 | ||||||||
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| AuthorizedOfficialLastName: | BOWMAN | ||||||||
| AuthorizedOfficialFirstName: | KATHRYN | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | PSYCHIATRIST | ||||||||
| AuthorizedOfficialTelephone: | 5046243056 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | C8317 | AR | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | 125738001 | 05 | AR | MEDICAID |