MEDICARE: DAVID MCDOWELL PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant

General Provider Information

NPI Number	:	1235595992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID MCDOWELL PA-C

Provider Business Mailing Address
First Line	:	650 JOEL DR
Second Line	:
City	:	FORT CAMPBELL
State	:	KY
Zip	:	42223-5318
Country	:	US
Telephone Number	:	270-798-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	9040 JACKSON AVENUE
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98431-5318
Country	:	US
Telephone Number	:	253-477-3751
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/12/2016
Last Update Date	:	04/10/2024

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