Healthcare Provider Details

I. General information

NPI: 1922197797
Provider Name (Legal Business Name): RONALD W DOWNING OD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 07/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

135 S KENNEBEC AVE
MC CONNELSVILLE OH
43756-1211
US

IV. Provider business mailing address

135 S KENNEBEC AVE
MC CONNELSVILLE OH
43756-1211
US

V. Phone/Fax

Practice location:
  • Phone: 740-962-4567
  • Fax: 740-962-3473
Mailing address:
  • Phone: 740-962-4567
  • Fax: 740-962-3473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number2929
License Number StateOH

VIII. Authorized Official

Name: MR. RONALD W DOWNING
Title or Position: OWNER
Credential: OD
Phone: 740-962-4567