Provider Demographics
NPI:1235188079
Name:MCDOWELL, CHRISTOPHER ALLEN (OD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:ALLEN
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 22ND ST
Mailing Address - Street 2:APT 301
Mailing Address - City:CLOQUET
Mailing Address - State:MN
Mailing Address - Zip Code:55720-2876
Mailing Address - Country:US
Mailing Address - Phone:773-495-9669
Mailing Address - Fax:
Practice Address - Street 1:1001 CLOQUET AVE
Practice Address - Street 2:
Practice Address - City:CLOQUET
Practice Address - State:MN
Practice Address - Zip Code:55720-1617
Practice Address - Country:US
Practice Address - Phone:612-730-3824
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2974152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN490P1MCOtherBCBS OF MN
MN22-03366OtherMEDICA VIRGINIA
MN42567OtherSPECTERA VIRGINIA
MNMN2974OtherEYE MED
MN22-03365OtherMEDICA CLOQUET
MNB25741045969OtherPREFERRED ONE
MN42566OtherSPECTERA CLOQUET
MNMN2974OtherEYE MED