Basic Information
Provider Information
NPI: 1396145835
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BOWERS
FirstName: WILLIAM
MiddleName: SONNY
NamePrefix: MR.
NameSuffix: II
Credential: AA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 288
Address2:  
City: HUNTSVILLE
State: AL
PostalCode: 358040288
CountryCode: US
TelephoneNumber: 2568806711
FaxNumber:  
Practice Location
Address1: 3001 W DR MARTIN LUTHER KING JR BLVD
Address2:  
City: TAMPA
State: FL
PostalCode: 336076307
CountryCode: US
TelephoneNumber: 8133507244
FaxNumber: 8133507246
Other Information
ProviderEnumerationDate: 09/03/2014
LastUpdateDate: 05/18/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/18/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
367H00000XAA.855ALY Physician Assistants & Advanced Practice Nursing ProvidersAnesthesiologist Assistant 

No ID Information.


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