Provider Demographics
NPI:1326190349
Name:MCDOWELL, JOSEPH OWEN
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:OWEN
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:SCOTLAND NECK
Mailing Address - State:NC
Mailing Address - Zip Code:27874-0160
Mailing Address - Country:US
Mailing Address - Phone:252-826-5963
Mailing Address - Fax:
Practice Address - Street 1:1004 MAIN ST
Practice Address - Street 2:
Practice Address - City:SCOTLAND NECK
Practice Address - State:NC
Practice Address - Zip Code:27874-1232
Practice Address - Country:US
Practice Address - Phone:252-826-4137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC07820183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0425058Medicaid
NC0425058Medicaid
NC0129180001Medicare ID - Type Unspecified