Provider Demographics
NPI:1962929745
Name:DOWNS, JOHN WILLIAM JR
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:DOWNS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:JOHN
Other - Middle Name:WILLIAM
Other - Last Name:DOWNS
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:400 E JEFF DAVIS AVE
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:38930-2316
Mailing Address - Country:US
Mailing Address - Phone:662-299-8982
Mailing Address - Fax:662-887-5457
Practice Address - Street 1:204 HIGHWAY 82 W
Practice Address - Street 2:
Practice Address - City:INDIANOLA
Practice Address - State:MS
Practice Address - Zip Code:38751-2133
Practice Address - Country:US
Practice Address - Phone:662-887-5471
Practice Address - Fax:662-887-5457
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-23
Last Update Date:2017-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-3924183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist