Provider Demographics
NPI:1669405700
Name:DOWLING, CLAREY R (MD)
Entity type:Individual
Prefix:
First Name:CLAREY
Middle Name:R
Last Name:DOWLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2569 N WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:BROWNSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38012-1610
Mailing Address - Country:US
Mailing Address - Phone:731-772-4411
Mailing Address - Fax:731-772-2664
Practice Address - Street 1:2569 N WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TN
Practice Address - Zip Code:38012-1610
Practice Address - Country:US
Practice Address - Phone:731-772-4411
Practice Address - Fax:731-772-2664
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-09
Last Update Date:2009-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD0000012699207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3387277Medicaid
TNBO3921Medicare UPIN
3387277Medicare ID - Type Unspecified