Provider Demographics
NPI:1184654857
Name:MEADVILLE PEDIATRICS, PC
Entity Type:Organization
Organization Name:MEADVILLE PEDIATRICS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:M
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:814-336-6384
Mailing Address - Street 1:765 LIBERTY ST
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MEADVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:16335-2566
Mailing Address - Country:US
Mailing Address - Phone:814-336-6384
Mailing Address - Fax:814-336-1372
Practice Address - Street 1:765 LIBERTY ST
Practice Address - Street 2:SUITE 111
Practice Address - City:MEADVILLE
Practice Address - State:PA
Practice Address - Zip Code:16335-2566
Practice Address - Country:US
Practice Address - Phone:814-336-6384
Practice Address - Fax:814-336-1372
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2011-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty