Provider Demographics
NPI:1316627458
Name:BOWMAN, DONNIE RAY JR (PHARMD)
Entity type:Individual
Prefix:
First Name:DONNIE
Middle Name:RAY
Last Name:BOWMAN
Suffix:JR
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:DJ
Other - Middle Name:
Other - Last Name:BOWMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:9701 E 71ST TER
Mailing Address - Street 2:
Mailing Address - City:RAYTOWN
Mailing Address - State:MO
Mailing Address - Zip Code:64133-6544
Mailing Address - Country:US
Mailing Address - Phone:417-321-0529
Mailing Address - Fax:
Practice Address - Street 1:3411 S NOLAND RD
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64055-1319
Practice Address - Country:US
Practice Address - Phone:816-252-0094
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2023028924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist