Healthcare Provider Details

I. General information

NPI: 1215250584
Provider Name (Legal Business Name): DOWNING OPTOMETRIST PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/01/2010
Last Update Date: 09/16/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

279 N GARDNER ST SUITE 2
SCOTTSBURG IN
47170-1322
US

IV. Provider business mailing address

279 N GARDNER ST SUITE 2
SCOTTSBURG IN
47170-1322
US

V. Phone/Fax

Practice location:
  • Phone: 812-752-5106
  • Fax: 812-752-5132
Mailing address:
  • Phone: 812-752-5106
  • Fax: 812-752-5132

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18001976
License Number StateIN

VIII. Authorized Official

Name: DR. DONN BARRY DOWNING
Title or Position: OWNER
Credential: OD
Phone: 812-752-5106