Doctor Name: | DR. JOHN LANDIS BOWMAN |
NPI Number: | 1528048410 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | |
Business Practice Address: | Health Services Northern Illinois University Dekalb, IL - 601152854 |
Business Phone Number: | 8157531311 |
Business Fax Number: | 8157539599 |
Mailing Address: | 802 Sunnymeade Trail, DEKALB |
State: | IL |
Postal Code: | 601152350 |
Phone Number: | 8157568421 |
Fax Number: | |
NPI Enumeration Date: | 01/18/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |