Provider Demographics
NPI:1174811483
Name:BOWMAN, JESSICA HELENE (MD)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:HELENE
Last Name:BOWMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5700 SOUTHWYCK BLVD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43614-1509
Mailing Address - Country:US
Mailing Address - Phone:800-274-2158
Mailing Address - Fax:419-866-5453
Practice Address - Street 1:1600 MORGAN ST
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-3456
Practice Address - Country:US
Practice Address - Phone:319-524-7150
Practice Address - Fax:319-524-5317
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2016-12-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL036.109998207ZF0201X, 207ZP0102X
IAMD-40089207ZP0102X
AZ30376207ZP0102X
MO2014026426207ZP0102X
IN01049275A207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology