Provider Demographics
NPI:1972223121
Name:DOWDY, JACY
Entity Type:Individual
Prefix:
First Name:JACY
Middle Name:
Last Name:DOWDY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:614 SHARON AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:SHARON HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19079-2357
Mailing Address - Country:US
Mailing Address - Phone:610-400-3244
Mailing Address - Fax:
Practice Address - Street 1:614 SHARON AVE APT 2
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079-2357
Practice Address - Country:US
Practice Address - Phone:610-400-3244
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-29
Last Update Date:2022-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies