Provider Demographics
NPI:1811032014
Name:COURTENAY, DAWN LOWE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:LOWE
Last Name:COURTENAY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:DAWN
Other - Middle Name:C
Other - Last Name:LOWE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:213 N HURSTBOURNE PKWY
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5139
Practice Address - Country:US
Practice Address - Phone:502-327-5135
Practice Address - Fax:502-327-9475
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY48173207R00000X, 208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY48173OtherLICENSE