1568509198 NPI number — DR. CRAIG M DOWDEN M. D.,

Table of content: DR. CRAIG M DOWDEN M. D., (NPI 1568509198)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568509198 NPI number — DR. CRAIG M DOWDEN M. D.,

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOWDEN
Provider First Name:
CRAIG
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M. D.,
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568509198
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/12/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
770 MIDDLE ST
Provider Second Line Business Mailing Address:
SUITE B
Provider Business Mailing Address City Name:
FAIRHOPE
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
36532-1766
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
251-928-1191
Provider Business Mailing Address Fax Number:
251-928-4529

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
770 MIDDLE ST
Provider Second Line Business Practice Location Address:
SUITE B
Provider Business Practice Location Address City Name:
FAIRHOPE
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
36532-1766
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
251-928-1191
Provider Business Practice Location Address Fax Number:
251-928-4529
Provider Enumeration Date:
01/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 173000000X , with the licence number:  28528 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: 28528 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1568509198 . This is a "NPI" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 051009978 . This is a "BCBS" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".




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