Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2081P2900X | Pain Medicine | 031411 | GA |
NPI | 1104884246 |
---|---|
Provider Name | John Martin Downey |
First Address | Augusta, GA 30917-2959 |
Second Address | Augusta, GA 30907-6528 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2006 |
Last Update Date | 28/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00458224A | (05) | GA |
023641 | BCBS (01) | GA |
1083607-006 | CIGNA (01) | GA |
G31411 | (05) | SC |