KEVIN A DOUGLAS, DPM, Surgery, Foot & Ankle CORAM, NY

Contact Information

KEVIN A DOUGLAS, DPM

100 MIDDLE COUNTRY RD
CORAM, NY 11727-4412

Phone: 631-696-9636
Fax: 631-696-9635
Website:

Specialty	Taxonomy Code	Specialty Code	Provider Type
Surgery, Foot & Ankle	213ES0103X	48	Podiatry
Student in an Organized Health Care Education/Training Program	390200000X

Indicates primary specialty

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NPI Profile & details for KEVIN A DOUGLAS · (Male)

NPI #	`1174020598`
Status	Active
Credentials	DPM (Doctor of Podiatric Medicine)
Entity	Individual
Enumeration date	04/11/2018
Last updated	06/06/2022 - About 4 years ago
Sole proprietor ¹	No
Identifiers	NY License # N007168
Hospital affiliation(s)	JOHN T MATHER MEMORIAL HOSPITAL OF PORT JEFFERSON - (Acute Care) 75 NORTH COUNTRY ROAD PORT JEFFERSON, NY 11777

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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KEVIN A DOUGLAS, DPM – NPI #1174020598Surgery, Foot & Ankle

Contact Information

Specialty

Surgery, Foot & Ankle

Student in an Organized Health Care Education/Training Program

NPI Profile & details for KEVIN A DOUGLAS · (Male)

Reviews for KEVIN A DOUGLAS

KEVIN A DOUGLAS, DPM – NPI #1174020598
Surgery, Foot & Ankle