Provider Demographics
NPI:1447543509
Name:DOWNIE, DAVID BRUCE (RPH)
Entity type:Individual
Prefix:MR
First Name:DAVID
Middle Name:BRUCE
Last Name:DOWNIE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:124 S MORRIS ST
Mailing Address - Street 2:
Mailing Address - City:STOUGHTON
Mailing Address - State:WI
Mailing Address - Zip Code:53589-2230
Mailing Address - Country:US
Mailing Address - Phone:608-873-5265
Mailing Address - Fax:608-838-8329
Practice Address - Street 1:4880 LARSON BEACH RD
Practice Address - Street 2:
Practice Address - City:MC FARLAND
Practice Address - State:WI
Practice Address - Zip Code:53558-8724
Practice Address - Country:US
Practice Address - Phone:608-838-7455
Practice Address - Fax:608-838-8329
Is Sole Proprietor?:No
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12054-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist