Healthcare Provider Details

I. General information

NPI: 1952574626
Provider Name (Legal Business Name): JORDAN PAUL DOWNING DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/02/2008
Last Update Date: 08/07/2025
Certification Date: 08/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

56TH MEDICAL GROUP 7219 N. LITCHFIELD RD
LUKE AFB AZ
85309
US

IV. Provider business mailing address

56TH MEDICAL GROUP 7219 N. LITCHFIELD RD
LUKE AFB AZ
85309
US

V. Phone/Fax

Practice location:
  • Phone: 623-856-7500
  • Fax:
Mailing address:
  • Phone: 623-856-7500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO.000188
License Number StateLA
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberR7202
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: