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Contact Information

GEOFFREY DOUGLAS, MD
1707 W CHARLESTON BLVD STE 160
LAS VEGAS, NV89102-2354
 Phone: 701-671-5150
 Fax: 702-384-6493
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Trauma Surgery

2086S0127X 02 Physician/General Surgery
 

Surgery

208600000X 02 Physician/General Surgery
 

Surgical Critical Care

2086S0102X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for GEOFFREY DOUGLAS · (Male)

NPI Number 1346456399
Status Active
Credentials MD
Entity Individual
Enumeration date 05/15/2007
Last updated 02/04/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • AL License # MD.32676
  • CA License # A101528
  • FL License # ME127855
  • NV License # 16532
  • WI License # 63460
  • FL Medicaid 113025700
Hospital affiliation(s)
  • FORT WALTON BEACH MEDICAL CENTER - (Acute Care)
    1000 MAR-WALT DR
    FORT WALTON BEACH, FL 32547
  • KERN MEDICAL CENTER - (Acute Care)
    1700 MOUNT VERNON AVENUE
    BAKERSFIELD, CA 93306
  • TAMPA GENERAL HOSPITAL - (Acute Care)
    1 TAMPA GENERAL CIR
    TAMPA, FL 33606
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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