MEDICARE: MARCUCHIO DOWNING

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1568944890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCUCHIO DOWNING

Provider Business Mailing Address
First Line	:	1912 NW 12TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-2200
Country	:	US
Telephone Number	:	405-887-2612
Fax Number	:

Provider Business Practice Location Address
First Line	:	1912 NW 12TH ST
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73106-2200
Country	:	US
Telephone Number	:	405-887-2612
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/04/2018
Last Update Date	:	09/04/2018

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Directions to “ MARCUCHIO DOWNING ” Practice Location

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