Provider Demographics
NPI:1750389516
Name:DOWNS, STEPHEN DYER (MD)
Entity type:Individual
Prefix:
First Name:STEPHEN
Middle Name:DYER
Last Name:DOWNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 NORTH BLVD
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALEXANDRIA
Mailing Address - State:LA
Mailing Address - Zip Code:71301-3606
Mailing Address - Country:US
Mailing Address - Phone:318-443-4576
Mailing Address - Fax:318-449-5579
Practice Address - Street 1:900 S 6TH ST
Practice Address - Street 2:
Practice Address - City:LEESVILLE
Practice Address - State:LA
Practice Address - Zip Code:71446-4723
Practice Address - Country:US
Practice Address - Phone:337-392-8118
Practice Address - Fax:817-284-9859
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA12683R207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1542857Medicaid
LA0867910001Medicare NSC
LA1542857Medicaid
LA5A875B059Medicare ID - Type Unspecified
LACT1911Medicare PIN