| James T Bowlus Md Inc | |
|
610 E Kiracofe Ave Elida OH 45807-1034 | |
| (419) 331-0443 | |
| (419) 331-3137 |
| Full Name | James T Bowlus Md Inc |
|---|---|
| Speciality | Family Medicine |
| Location | 610 E Kiracofe Ave, Elida, Ohio |
| Authorized Official Name and Position | James T Bowlus (PRESIDENT) |
| Authorized Official Contact | 4193310443 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James T Bowlus Md Inc Po Box 3097 Elida OH 45807-0097 Ph: (419) 331-0443 | James T Bowlus Md Inc 610 E Kiracofe Ave Elida OH 45807-1034 Ph: (419) 331-0443 |
| NPI Number | 1336336577 |
|---|---|
| Provider Enumeration Date | 10/02/2007 |
| Last Update Date | 11/15/2007 |
| Medicare PECOS PAC ID | 3577687151 |
|---|---|
| Medicare Enrollment ID | O20100903000064 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1336336577 | NPI | - | NPPES |
| 012675073 | Other | OH | RAILROAD MEDICARE |
| 0305146 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 35036062 (Ohio) | Primary |
| Provider Name | James Theodore Bowlus |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1841263589 PECOS PAC ID: 4486778065 Enrollment ID: I20100903000076 |
Lima Memorial Professional Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 610 E Kiracofe Ave, Elida, OH 45807 Phone: 419-331-0443 Fax: 419-331-3137 |