Basic Information
| Provider Information | |||||||||
| NPI: | 1477533024 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOWMAN | ||||||||
| FirstName: | KATHRYN | ||||||||
| MiddleName: | DONITA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 8369 | ||||||||
| Address2: | |||||||||
| City: | HOT SPRINGS VILLAGE | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719108369 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5016243056 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 2426 BUHNE ST | ||||||||
| Address2: | |||||||||
| City: | EUREKA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 955013207 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7074434666 | ||||||||
| FaxNumber: | 7074454499 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/19/2006 | ||||||||
| LastUpdateDate: | 07/17/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | C-8317 | AR | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0800X | C163360 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry |
ID Information
| ID | Type | State | Issuer | Description | BB7456519 | 01 | AR | DEA | OTHER |