Healthcare Provider Details

I. General information

NPI: 1750300794
Provider Name (Legal Business Name): MARY K DOWNS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2006
Last Update Date: 07/01/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2741 DEBARR RD STE 413
ANCHORAGE AK
99508-2998
US

IV. Provider business mailing address

PO BOX 241769
ANCHORAGE AK
99524
US

V. Phone/Fax

Practice location:
  • Phone: 907-277-1623
  • Fax: 907-277-1624
Mailing address:
  • Phone: 907-770-2380
  • Fax: 907-770-2341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number3677
License Number StateAK

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
IdentifierMD0399
Identifier TypeMEDICAID
Identifier StateAK
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: