Provider Demographics
NPI:1326517665
Name:DOWNING, EMMETT (LDO)
Entity Type:Individual
Prefix:MR
First Name:EMMETT
Middle Name:
Last Name:DOWNING
Suffix:
Gender:M
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2337 W NORTHERN AVE
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85021-4918
Mailing Address - Country:US
Mailing Address - Phone:602-995-8848
Mailing Address - Fax:602-995-2980
Practice Address - Street 1:2337 W NORTHERN AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85021-4918
Practice Address - Country:US
Practice Address - Phone:602-995-8848
Practice Address - Fax:602-995-2980
Is Sole Proprietor?:No
Enumeration Date:2018-11-15
Last Update Date:2018-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLDO-002652156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician