| Name: | John W. Bowman, MD, LLC |
| Jurisdiction: | Alabama |
| Legal type: | Domestic Limited Liability Company |
| Status: | Exists |
| Date of registration: | 27 Nov 2013 (11 years ago) |
| Entity Number: | 000-292-299 |
| Register Number: | 000292299 |
| ZIP code: | 35802 |
| County: | Madison |
| Place of Formation: | Madison County |
| Registered Office Street Address: | 8678 EDGEHILL DRIVE SEHUNTSVILLE, AL 35802 |
Activities
PROFESSIONAL MEDICAL SERVICES
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1114358710 | 2013-12-06 | 2013-12-06 | 8678 EDGEHILL DR SE, HUNTSVILLE, AL, 358023786, US | 4810 WHITESPORT CIR SW, SUITE 105, HUNTSVILLE, AL, 358017419, US | |||||||||||||||||||||||||||||
|
|||||||||||||||||||||||||||||||||
| Phone | +1 256-505-6826 |
| Fax | 2565821100 |
| Phone | +1 256-429-5390 |
| Fax | 2564295933 |
Authorized person
| Name | DR. JOHN W BOWMAN |
| Role | OWNER/PHYSICIAN |
| Phone | 2565056826 |
Taxonomy
| Taxonomy Code | 208D00000X - General Practice Physician |
| License Number | 10852 |
| State | AL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | INDIVIDUAL NPI |
| Number | 1093808826 |
| State | AL |
| Name | Role | Address |
|---|---|---|
| FREDERICK, PAUL W | Organizer | 655 GALLATIN STREETHUNTSVILLE, AL 35801 |
| BOWMAN, JOHN W | Organizer | 8678 EDGEHILL DRIVE SEHUNTSVILLE, AL 35802 |
| Name | Role | Address |
|---|---|---|
| BOWMAN, JOHN W | Agent | 8678 EDGEHILL DRIVE SEHUNTSVILLE, AL 35802 |
Date of last update: 02 Aug 2024
Sources: Alabama Secretary of State
