Basic Information
| Provider Information | |||||||||
| NPI: | 1316930621 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | BOWLING | ||||||||
| FirstName: | MARCIA | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5053 WOOSTER RD | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452262326 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137512145 | ||||||||
| FaxNumber: | 5137512138 | ||||||||
| Practice Location | |||||||||
| Address1: | 71 E HOLLISTER ST | ||||||||
| Address2: | |||||||||
| City: | CINCINNATI | ||||||||
| State: | OH | ||||||||
| PostalCode: | 452191703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5137512273 | ||||||||
| FaxNumber: | 5137511840 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/23/2005 | ||||||||
| LastUpdateDate: | 02/04/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 30098 | KY | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207V00000X | 35054486 | OH | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 64863095 | 05 | KY | MEDICAID | 980000325 | 01 | OH | MEDICARE RAILROAD | OTHER | 0638813 | 05 | OH | MEDICAID | 980000327 | 01 | KY | MEDICARE RAILROAD | OTHER | 100378600 | 05 | IN | MEDICAID |