Healthcare Provider Details

I. General information

NPI: 1144377227
Provider Name (Legal Business Name): DONALD DEAN DOWDY JR. PHYSICAL THERAPIST
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 08/25/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

532 C CARATOKE HIGHWAY
MOYOCK NC
27958
US

IV. Provider business mailing address

101 MEDICAL DR
ELIZABETH CITY NC
27909
US

V. Phone/Fax

Practice location:
  • Phone: 252-435-6046
  • Fax: 252-435-6210
Mailing address:
  • Phone: 252-338-2114
  • Fax: 252-338-2115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number8414
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: