Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207W00000X | Ophthalmologist | 13422 | KY |
NPI | 1023008729 |
---|---|
Provider Name | Dr. John Edward Downing |
First Address | Bowling Green, KY 42104-3379 |
Second Address | Bowling Green, KY 42104-3379 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/10/2005 |
Last Update Date | 14/08/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
64134224 | (05) | KY |
C71152 | (02) | KY |