Basic Information
Provider Information
NPI: 1366497786
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOWNING
FirstName: DIANE
MiddleName: C
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 81 W ESPERANZA BLVD
Address2: STE 201
City: GREEN VALLEY
State: AZ
PostalCode: 856142667
CountryCode: US
TelephoneNumber: 5206254401
FaxNumber: 5206258504
Practice Location
Address1: 275 W CONTINENTAL RD
Address2: STE 141
City: GREEN VALLEY
State: AZ
PostalCode: 856142024
CountryCode: US
TelephoneNumber: 5206253691
FaxNumber: 5205473994
Other Information
ProviderEnumerationDate: 05/24/2006
LastUpdateDate: 08/30/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X33052AZY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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