Basic Information
| Provider Information | |||||||||
| NPI: | 1164550372 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOWDEN | ||||||||
| FirstName: | KENT | ||||||||
| MiddleName: | CALVIN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 927 S CARMEL ST | ||||||||
| Address2: | |||||||||
| City: | CADILLAC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 496012547 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2318763876 | ||||||||
| FaxNumber: | 2317751115 | ||||||||
| Practice Location | |||||||||
| Address1: | 927 S CARMEL ST | ||||||||
| Address2: | |||||||||
| City: | CADILLAC | ||||||||
| State: | MI | ||||||||
| PostalCode: | 49601 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2318763876 | ||||||||
| FaxNumber: | 2317751115 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/01/2007 | ||||||||
| LastUpdateDate: | 10/13/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/13/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 5101016414 | MI | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.