Provider Demographics
NPI:1366657793
Name:DOWDEN, JACOB EMILE (MD)
Entity Type:Individual
Prefix:DR
First Name:JACOB
Middle Name:EMILE
Last Name:DOWDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1514 JEFFERSON HWY
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70121-2429
Mailing Address - Country:US
Mailing Address - Phone:504-842-4000
Mailing Address - Fax:
Practice Address - Street 1:200 W ESPLANADE AVE STE 210
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70065-2473
Practice Address - Country:US
Practice Address - Phone:504-464-8588
Practice Address - Fax:504-464-8586
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47948204F00000X, 208600000X
LA321432208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ013834Medicaid
GA003163304AMedicaid
AL174605Medicaid
TNP01476784OtherPTAN
103I028218Medicare PIN