Healthcare Provider Details

I. General information

NPI: 1821089038
Provider Name (Legal Business Name): J MICHAEL O'DOWD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/04/2005
Last Update Date: 05/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 SPRING HILL AVE SUITE 100
MOBILE AL
36604-1407
US

IV. Provider business mailing address

1700 SPRING HILL AVE SUITE 100
MOBILE AL
36604-1407
US

V. Phone/Fax

Practice location:
  • Phone: 251-435-1200
  • Fax: 251-435-6357
Mailing address:
  • Phone: 251-435-1200
  • Fax: 251-435-6357

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number12245
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number12245
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: