Basic Information
| Provider Information | |||||||||
| NPI: | 1023456258 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOWER | ||||||||
| FirstName: | ALEC | ||||||||
| MiddleName: | DOUGLAS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1338 PHAY AVE | ||||||||
| Address2: | |||||||||
| City: | CANON CITY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 812122311 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5176171939 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1338 PHAY AVE | ||||||||
| Address2: | |||||||||
| City: | CANON CITY | ||||||||
| State: | CO | ||||||||
| PostalCode: | 81212 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7192852000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/10/2013 | ||||||||
| LastUpdateDate: | 07/31/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 34.011617 | OH | N | Allopathic & Osteopathic Physicians | Emergency Medicine | 390200000X | OH | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207P00000X | DR.0057988 | CO | Y | Allopathic & Osteopathic Physicians | Emergency Medicine |
No ID Information.