Provider Demographics
NPI:1457890824
Name:DOW, JAMES RICHARD II (EMT-I, SWAT MEDIC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RICHARD
Last Name:DOW
Suffix:II
Gender:M
Credentials:EMT-I, SWAT MEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4925 SURREY DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30075-1634
Mailing Address - Country:US
Mailing Address - Phone:404-988-6756
Mailing Address - Fax:
Practice Address - Street 1:4925 SURREY DR
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30075-1634
Practice Address - Country:US
Practice Address - Phone:404-988-6756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-18
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
247200000X
GA44323146M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA44323OtherSTATE CERTIFIED INTERMEDIATE EMERGENCY MEDICAL TECHNICIAN