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Contact Information

DOUGLAS MEDICAL SPECIALIST
134 E FLEETWOOD AVE
WILLACOOCHEE, GA31650
 Phone: 912-384-3338
 Fax: 912-383-6365
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
Indicates primary specialty

NPI Profile & details for DOUGLAS MEDICAL SPECIALIST · (Female)

NPI # 1114114055
Status Active
Credentials
Entity Individual
Enumeration date 09/25/2007
Last updated 10/30/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 056658
  • GA Other 1225021678 NPI
  • GA Other 1326031865 NPI
  • GA Other 1750374294 NPI
  • GA Other 1891815924 NPI
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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