Provider Demographics
NPI:1295719425
Name:MCDOWELL, JASON ARTHUR (PT)
Entity type:Individual
Prefix:MR
First Name:JASON
Middle Name:ARTHUR
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
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Mailing Address - Street 1:1702 BRIAN WILLIAM RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28212-7603
Mailing Address - Country:US
Mailing Address - Phone:704-577-2899
Mailing Address - Fax:704-366-3233
Practice Address - Street 1:4421 SHARON RD STE 100
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28211-5585
Practice Address - Country:US
Practice Address - Phone:704-366-3220
Practice Address - Fax:704-366-3233
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-01
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC91202251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2503590AMedicare PIN
NCQ38017AMedicare PIN