Provider Demographics
NPI:1841574506
Name:DOWTY, ALLEN MARK (RPH)
Entity Type:Individual
Prefix:MR
First Name:ALLEN
Middle Name:MARK
Last Name:DOWTY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:430 N LAKE ST
Mailing Address - Street 2:
Mailing Address - City:BOYNE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49712-1104
Mailing Address - Country:US
Mailing Address - Phone:231-582-2101
Mailing Address - Fax:
Practice Address - Street 1:430 N LAKE ST
Practice Address - Street 2:
Practice Address - City:BOYNE CITY
Practice Address - State:MI
Practice Address - Zip Code:49712-1104
Practice Address - Country:US
Practice Address - Phone:231-582-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5302028254183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist