Provider Demographics
NPI:1205857042
Name:DOWNS, MATTHEW R (OD)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:R
Last Name:DOWNS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MANKATO
Mailing Address - State:MN
Mailing Address - Zip Code:56001-3574
Mailing Address - Country:US
Mailing Address - Phone:507-345-5087
Mailing Address - Fax:507-345-1151
Practice Address - Street 1:120 N BROAD ST
Practice Address - Street 2:
Practice Address - City:MANKATO
Practice Address - State:MN
Practice Address - Zip Code:56001-3518
Practice Address - Country:US
Practice Address - Phone:507-345-5087
Practice Address - Fax:507-345-1151
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2911152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U92783Medicare UPIN