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General NPI Number Information
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NPI Number | 1952745358
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Entity Type | Individual
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Provider Name | THOMAS JACKSON DOWNEY P.A.C.
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Gender | Male
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 02/27/2023
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Provider Practice Location Address
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Address Line | 5964 NORMANDY BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32205-6212
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Country | US
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Telephone | 904-378-0121
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Fax |
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Provider Business Mailing Address
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Address Line | 5964 NORMANDY BLVD
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City | JACKSONVILLE
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State | FL
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Zip | 32205-6212
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Country | US
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Telephone | 904-378-0121
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | PA-898
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA9109946
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License Number State | FL
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