Provider Demographics
NPI:1609859099
Name:DOWNING, JIMMY W (DPM)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:W
Last Name:DOWNING
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:600 PETER JEFFERSON PKWY
Mailing Address - Street 2:SUITE 360
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-8608
Mailing Address - Country:US
Mailing Address - Phone:434-979-0763
Mailing Address - Fax:434-979-8681
Practice Address - Street 1:600 PETER JEFFERSON PKWY
Practice Address - Street 2:SUITE 360
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-8835
Practice Address - Country:US
Practice Address - Phone:434-979-0763
Practice Address - Fax:434-979-8681
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-21
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0103000426213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA144959OtherSO HEALTH
VA118109OtherANTHEM
VA009303995Medicaid
T21908Medicare UPIN
VA009303995Medicaid