Provider Demographics
NPI:1275583601
Name:DOWDY, DAVID S (PT, DPT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:DOWDY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8823 PRODUCTION LN
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-6511
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:2001 N STATE ROUTE 7
Practice Address - Street 2:
Practice Address - City:PLEASANT HILL
Practice Address - State:MO
Practice Address - Zip Code:64080-9303
Practice Address - Country:US
Practice Address - Phone:816-987-7122
Practice Address - Fax:816-565-4233
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2002005834225100000X
KS1103297225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSKA2868030OtherMEDICARE PTAN
KS1275583601OtherBCBS KS
MOMA4370006OtherMEDICARE PTAN
33526146OtherBCBS KC
MOT07000009Medicare PIN