Individual
MRS. KIMBERLY A MCDOWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
219T
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120705901
—
WY
01
—
410025406
PALMETTO RAILROAD MEDICAR
WY
01
—
W306541
MEDICARE ID-PIN
WY
Enumeration date
11/21/2006
Last updated
09/27/2012
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