Provider Demographics
NPI:1225111289
Name:DOWD, JUDY A (PA-C)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:A
Last Name:DOWD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:JUDY
Other - Middle Name:A
Other - Last Name:MCDANIEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:2902 SW ASBURY DR
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66614-4466
Mailing Address - Country:US
Mailing Address - Phone:785-270-0187
Mailing Address - Fax:785-270-0168
Practice Address - Street 1:2902 SW ASBURY DR
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66614-4466
Practice Address - Country:US
Practice Address - Phone:785-270-0187
Practice Address - Fax:785-270-0168
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS15-00481363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100362510AMedicaid
KS042340OtherMEDICARE PTAN
KS100362510AMedicaid