Provider Demographics
NPI:1699059550
Name:MCDOWELL, DAVID JAMISON (PHD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:JAMISON
Last Name:MCDOWELL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1220 CUMBERLAND RD
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37419-1008
Mailing Address - Country:US
Mailing Address - Phone:423-316-8695
Mailing Address - Fax:423-821-2067
Practice Address - Street 1:3097 S. BROAD ST.
Practice Address - Street 2:
Practice Address - City:CHATTANOOGA
Practice Address - State:TN
Practice Address - Zip Code:37408
Practice Address - Country:US
Practice Address - Phone:423-316-8695
Practice Address - Fax:423-821-2067
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-10
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2601103TC0700X
MA2815103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical