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Individual

CAROL SUE DOWNARD

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
AU.D

Contact information

Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2479
(765) 448-8000
(765) 448-8335
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
(765) 448-8335

Taxonomy

Speciality
Code
Description
License number
State
231H00000X
Audiologist
23001875A
IN
237600000X
Audiologist-Hearing Aid Fitter
Primary
23001875A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000197998
ANTHEM PROVIDER NUMBER
IN
05
100087950
IN
01
9397771
PHCS PID NUMBER
IN
05
DO15692064
IN
Enumeration date
03/23/2006
Last updated
02/08/2012
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