Provider Demographics
NPI:1144377227
Name:DOWDY, DONALD DEAN JR (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:DEAN
Last Name:DOWDY
Suffix:JR
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 MEDICAL DR
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909
Mailing Address - Country:US
Mailing Address - Phone:252-338-2114
Mailing Address - Fax:252-338-2115
Practice Address - Street 1:532 C CARATOKE HIGHWAY
Practice Address - Street 2:
Practice Address - City:MOYOCK
Practice Address - State:NC
Practice Address - Zip Code:27958
Practice Address - Country:US
Practice Address - Phone:252-435-6046
Practice Address - Fax:252-435-6210
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC84142251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7210910Medicaid
NC078CFOtherBCBS
NC250218Medicare PIN
NC271572BMedicare PIN
NC7210910Medicaid