Healthcare Provider Details

I. General information

NPI: 1841398476
Provider Name (Legal Business Name): HEATHER RENEE DOWNHOUR MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 11/27/2023
Certification Date: 09/01/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

145 GREEN MEADOWS DRIVE SUITE 1
GREENFIELD IN
46140-4002
US

IV. Provider business mailing address

6626 E 75TH STREET SUITE 500
INDIANAPOLIS IN
46250-2890
US

V. Phone/Fax

Practice location:
  • Phone: 317-462-1481
  • Fax:
Mailing address:
  • Phone: 317-621-7561
  • Fax: 317-355-6096

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number01062361A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: