Provider Demographics
NPI:1447299888
Name:DOWNS, HENRY (MD)
Entity type:Individual
Prefix:
First Name:HENRY
Middle Name:
Last Name:DOWNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 IRONWOOD DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814
Mailing Address - Country:US
Mailing Address - Phone:208-292-1315
Mailing Address - Fax:208-765-0627
Practice Address - Street 1:980 IRONWOOD DR
Practice Address - Street 2:SUITE 201
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814
Practice Address - Country:US
Practice Address - Phone:208-292-1315
Practice Address - Fax:208-765-0627
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-04
Last Update Date:2007-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM8149207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID1100508Medicare ID - Type Unspecified
IDE01723Medicare UPIN