Basic Information
| Provider Information | |||||||||
| NPI: | 1548263692 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DOWLING | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | J | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 6077 PRIMACY PKWY STE 140 | ||||||||
| Address2: | |||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381195742 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9017258347 | ||||||||
| FaxNumber: | 9012597637 | ||||||||
| Practice Location | |||||||||
| Address1: | 6286 BRIARCREST AVE | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | MEMPHIS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 381204023 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9016413000 | ||||||||
| FaxNumber: | 9017012400 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2005 | ||||||||
| LastUpdateDate: | 03/17/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 03/17/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081P2900X | 31657 | TN | Y | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine | 208100000X | 31657 | TN | N | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
ID Information
| ID | Type | State | Issuer | Description | 00000016278 | 01 | TN | TLC | OTHER | 250010161 | 01 | TN | RAILROAD MEDICARE | OTHER | 3371161 | 05 | TN | MEDICAID | 620819926 | 01 | MS | BCBS | OTHER | 8686923 | 01 | TN | CIGNA | OTHER | 110318002 | 05 | AR | MEDICAID | 620819926 | 01 | TN | CIGNA | OTHER | 136785001 | 05 | AR | MEDICAID | 7187860 | 05 | MS | MEDICAID | 7331024 | 01 | TN | AETNA | OTHER | 3125383 | 01 | TN | BCBS | OTHER | 3840118 | 05 | TN | MEDICAID | 620819926 | 01 | TN | AETNA | OTHER | 620819926 | 01 | TN | TRICARE | OTHER | 000120792 | 05 | MS | MEDICAID |