Provider Demographics
NPI:1326190174
Name:BOWIE, BILLY GENE (PHD)
Entity type:Individual
Prefix:MR
First Name:BILLY
Middle Name:GENE
Last Name:BOWIE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 89
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172
Mailing Address - Country:US
Mailing Address - Phone:615-382-0220
Mailing Address - Fax:615-382-0220
Practice Address - Street 1:203 5TH AVENUE EAST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172
Practice Address - Country:US
Practice Address - Phone:615-382-0220
Practice Address - Fax:615-382-0220
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNTNP1432103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist