Provider Demographics
NPI:1295930832
Name:JOWDY, JAMES ALBERT (DO)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:ALBERT
Last Name:JOWDY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:ALBERT
Other - Last Name:JOWDY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:13206 BEACON HILL WAY
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:VA
Mailing Address - Zip Code:23314-3584
Mailing Address - Country:US
Mailing Address - Phone:207-590-9748
Mailing Address - Fax:
Practice Address - Street 1:13206 BEACON HILL WAY
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:VA
Practice Address - Zip Code:23314-3584
Practice Address - Country:US
Practice Address - Phone:207-590-9748
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-15
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA20A10556208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program