Bacon, Douglas Richard
Bacon, Douglas Richard is an individual health care provider with primary practice located at 200 1St St Sw , Rochester MN 55905-0001. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anesthesiology, which is considered as his primary health care specialty. Bacon, Douglas Richard can be contacted via phone (507) 284-2511.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 23453 | Mississippi |
| Allopathic & Osteopathic Physicians / Anesthesiology | 207L00000X | 42805 | Minnesota |
Profile Details
| NPI number | 1386624765 |
|---|---|
| LBN Legal business name | Bacon, Douglas Richard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 20th, 2006 |
| Last updated | Jul 11th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386624765 | NPPES |
| Mississippi | MEDICAID | 05236703 | |
| Mississippi | MEDICAID | 094957400 |
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