Healthcare Provider Details

I. General information

NPI: 1831192871
Provider Name (Legal Business Name): DAVID COWDEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/16/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 W STONE DR STE 4D
KINGSPORT TN
37660-3256
US

IV. Provider business mailing address

PO BOX 9
KINGSPORT TN
37662-0009
US

V. Phone/Fax

Practice location:
  • Phone: 423-392-6299
  • Fax: 423-392-6920
Mailing address:
  • Phone: 423-857-2066
  • Fax: 423-857-2070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD9875
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: