Provider Demographics
NPI:1063801660
Name:BOWEN, JOHN CLAY (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:CLAY
Last Name:BOWEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6600 S YALE AVE STE 1200
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-3361
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11610 N 137TH EAST AVE
Practice Address - Street 2:
Practice Address - City:COLLINSVILLE
Practice Address - State:OK
Practice Address - Zip Code:74021-3601
Practice Address - Country:US
Practice Address - Phone:918-928-4180
Practice Address - Fax:918-928-4185
Is Sole Proprietor?:No
Enumeration Date:2015-01-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK5863207Q00000X, 207PE0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PE0004XAllopathic & Osteopathic PhysiciansEmergency MedicineEmergency Medical Services
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine