Provider Demographics
NPI:1104940774
Name:HERBERT H. BOWDEN
Entity type:Organization
Organization Name:HERBERT H. BOWDEN
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:HERBERT
Authorized Official - Middle Name:HORTON
Authorized Official - Last Name:BOWDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-539-9937
Mailing Address - Street 1:656 HONEYCOMB RD
Mailing Address - Street 2:
Mailing Address - City:GRANT
Mailing Address - State:AL
Mailing Address - Zip Code:35747-9378
Mailing Address - Country:US
Mailing Address - Phone:256-533-7881
Mailing Address - Fax:256-539-3333
Practice Address - Street 1:2010C FRANKLIN ST SE
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4514
Practice Address - Country:US
Practice Address - Phone:256-539-9937
Practice Address - Fax:256-539-3333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL19260174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALCG4620OtherRAILROAD MEDICARE GROUP #
AL051009438OtherBCBS PROVIDER NUMBER
AL000026246Medicaid
AL000026246Medicaid
ALA37364Medicare UPIN