Healthcare Provider Details

I. General information

NPI: 1437156270
Provider Name (Legal Business Name): JAMES G MCDOWELL JR. M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

417 NORTHCREST DR
SPRINGFIELD TN
37172-3973
US

IV. Provider business mailing address

417 NORTHCREST DR
SPRINGFIELD TN
37172-3973
US

V. Phone/Fax

Practice location:
  • Phone: 615-384-8211
  • Fax: 615-384-8211
Mailing address:
  • Phone: 615-384-8211
  • Fax: 615-384-5859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD36191
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: