Healthcare Provider Details

I. General information

NPI: 1043294051
Provider Name (Legal Business Name): DONN BARRY DOWNING OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2005
Last Update Date: 02/19/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 E TIPTON ST STE 2 SUITE 2
SEYMOUR IN
47274-3519
US

IV. Provider business mailing address

631 E TIPTON ST SUITE 2
SEYMOUR IN
47274-3519
US

V. Phone/Fax

Practice location:
  • Phone: 812-522-4444
  • Fax: 812-522-2634
Mailing address:
  • Phone: 812-522-4444
  • Fax: 812-522-2634

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18001976A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: