Provider Demographics
NPI:1477617686
Name:MCDOWELL, DALE S JR (MD)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:S
Last Name:MCDOWELL
Suffix:JR
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 1:2614 CLOVER ST
Mailing Address - Street 2:
Mailing Address - City:KLAMATH FALLS
Mailing Address - State:OR
Mailing Address - Zip Code:97601-1132
Mailing Address - Country:US
Mailing Address - Phone:541-884-6233
Mailing Address - Fax:541-880-2840
Practice Address - Street 1:2614 CLOVER ST
Practice Address - Street 2:
Practice Address - City:KLAMATH FALLS
Practice Address - State:OR
Practice Address - Zip Code:97601-1132
Practice Address - Country:US
Practice Address - Phone:541-884-6233
Practice Address - Fax:541-880-2840
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2024-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD11676207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR060029403OtherRAILROAD MEDICARE
OR245522Medicaid
OR060063048OtherRAILROAD MEDICARE
OR060061454OtherRAILROAD MEDICARE
R107503Medicare PIN
ORR108836Medicare PIN
ORC36014Medicare UPIN
ORR139955Medicare PIN