Provider Demographics
NPI:1992482541
Name:DOWNS, TIFFANY (CMF)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:DOWNS
Suffix:
Gender:F
Credentials:CMF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4108 SAINT CHARLES LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-3353
Mailing Address - Country:US
Mailing Address - Phone:502-210-3714
Mailing Address - Fax:
Practice Address - Street 1:1707 MELLWOOD AVE
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40206-1743
Practice Address - Country:US
Practice Address - Phone:502-509-5156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-05
Last Update Date:2023-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes224900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMastectomy FitterGroup - Single Specialty