Provider Demographics
NPI:1407900962
Name:MCDOWELL, LUCY JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:LUCY
Middle Name:JANE
Last Name:MCDOWELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4505 N WHEELING AVE
Mailing Address - Street 2:
Mailing Address - City:MUNCIE
Mailing Address - State:IN
Mailing Address - Zip Code:47304-1284
Mailing Address - Country:US
Mailing Address - Phone:765-284-4050
Mailing Address - Fax:765-284-9301
Practice Address - Street 1:4505 N WHEELING AVE
Practice Address - Street 2:
Practice Address - City:MUNCIE
Practice Address - State:IN
Practice Address - Zip Code:47304-1284
Practice Address - Country:US
Practice Address - Phone:765-284-4050
Practice Address - Fax:765-284-9301
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01025405207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN209340 BMedicare ID - Type Unspecified
IND69470Medicare UPIN