Basic Information
Provider Information | |||||||||
NPI: | 1609847391 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | DOWNARD | ||||||||
FirstName: | PATRICK | ||||||||
MiddleName: | J | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 320 WHITTINGTON PKWY | ||||||||
Address2: | SUITE 301 | ||||||||
City: | LOUISVILLE | ||||||||
State: | KY | ||||||||
PostalCode: | 402224928 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5026255584 | ||||||||
FaxNumber: | 5024262264 | ||||||||
Practice Location | |||||||||
Address1: | 1850 STATE ST | ||||||||
Address2: |   | ||||||||
City: | NEW ALBANY | ||||||||
State: | IN | ||||||||
PostalCode: | 471504990 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5026255584 | ||||||||
FaxNumber: | 5024262264 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/30/2006 | ||||||||
LastUpdateDate: | 05/04/2016 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 01060256A | IN | Y |   | Allopathic & Osteopathic Physicians | Anesthesiology |   |
ID Information
ID | Type | State | Issuer | Description | 000000365065 | 01 | IN | UNICARE | OTHER | 129703800 | 01 | IN | BLACK LUNG PROGRAM | OTHER | 50009627 | 01 |   | PASSPORT | OTHER | P00234057 | 01 | IN | RAILROAD MEDICARE | OTHER | 000000365065 | 01 | IN | INDIANA COMPREHENSIVE | OTHER | 129703800 | 01 | IN | US DEPT OF LABOR | OTHER | 134960G | 01 | IN | UNICARE MEDICARE | OTHER | 000000365065 | 01 | KY | ANTHEM | OTHER | 200512940 | 05 | IN |   | MEDICAID | 200512940 | 01 | IN | MANAGED HEALTH SERVICES | OTHER | 000000365065 | 01 | IN | HEALTHLINK | OTHER | 200512940 | 01 | IN | MDWISE HOOSIER ALLIANCE | OTHER | 7100082570 | 05 | KY |   | MEDICAID | 000000365065 | 01 | IN | ANTHEM | OTHER | 000000365065 | 01 | IN | ANTHEM SENIOR ADVANTAGE | OTHER | 000000365065 | 01 | IN | ONE NATION BENEFIT | OTHER | 000000365065 | 01 | IN | ANTHEM MEDICAID | OTHER | 2684352000 | 01 | IN | PASSPORT ADVANTAGE | OTHER |