1427507656 NPI number — MSH CLINIC

Table of content: ANN PAULINE BOWERS MD (NPI 1285658625)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427507656 NPI number — MSH CLINIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MSH CLINIC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1427507656
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/29/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
105 PATRIOT ST
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70508-6831
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
337-981-2125
Provider Business Mailing Address Fax Number:
337-981-2174

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
105 PATRIOT ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70508-6831
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
337-981-2125
Provider Business Practice Location Address Fax Number:
337-981-2174
Provider Enumeration Date:
09/29/2016

Additional Information

Authorized Official

Authorized Official Last Name:
BRENNAN
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
A
Authorized Official Title or Position:
MEMBER
Authorized Official Telephone Number:
337-981-2125

Provider Taxonomy Codes

  • Taxonomy code: 208VP0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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