Healthcare Provider Details

I. General information

NPI: 1255370482
Provider Name (Legal Business Name): JAMES W MCDOWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 07/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 N RUTHERFORD ST
MACON MO
63552-2020
US

IV. Provider business mailing address

1205 N MISSOURI ST
MACON MO
63552-2095
US

V. Phone/Fax

Practice location:
  • Phone: 660-385-8900
  • Fax: 660-385-8708
Mailing address:
  • Phone: 660-385-8700
  • Fax: 660-385-8701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD101614
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: