Provider Demographics
NPI:1548263692
Name:DOWLING, DAVID J (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:J
Last Name:DOWLING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6077 PRIMACY PKWY STE 140
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-5742
Mailing Address - Country:US
Mailing Address - Phone:901-725-8347
Mailing Address - Fax:901-259-7637
Practice Address - Street 1:6286 BRIARCREST AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38120-4023
Practice Address - Country:US
Practice Address - Phone:901-641-3000
Practice Address - Fax:901-701-2400
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN316572081P2900X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN00000016278OtherTLC
TN250010161OtherRAILROAD MEDICARE
TN3371161Medicaid
MS620819926OtherBCBS
TN8686923OtherCIGNA
AR110318002Medicaid
TN620819926OtherCIGNA
AR136785001Medicaid
MS7187860Medicaid
TN7331024OtherAETNA
TN3125383OtherBCBS
TN3840118Medicaid
TN620819926OtherAETNA
TN620819926OtherTRICARE
MS000120792Medicaid
MS7187860Medicaid
AR136785001Medicaid
TN8686923OtherCIGNA