Douchy, Charles Jacob

Douchy, Charles Jacob is an individual health care provider with primary practice located at 3850 Pleasant Hill Rd , Duluth GA 30096-4807. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Dermatology, Allopathic & Osteopathic Physicians / Dermatopathology, Allopathic & Osteopathic Physicians / Procedural Dermatology. Allopathic & Osteopathic Physicians / Dermatology is his primary health care specialty. Douchy, Charles Jacob can be contacted via phone (770) 814-8222.

Contact Information

Primary practice address
3850 Pleasant Hill Rd Duluth GA 30096-4807
Phone: (770) 814-8222
Fax: (678) 205-5111
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Dermatology 207N00000X 040052 Georgia
Allopathic & Osteopathic Physicians / Dermatopathology 207ND0900X 040052 Georgia
Allopathic & Osteopathic Physicians / Procedural Dermatology 207NS0135X 040052 Georgia

Profile Details

NPI number 1003808361
LBN Legal business name Douchy, Charles Jacob
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 22nd, 2005
Last updated Oct 2nd, 2015 - about 10 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003808361 NPPES
Georgia MEDICAID 00663396B
Georgia Other 2498075
Georgia Other 912915
Georgia MEDICAID 000663396E
Georgia Other 070014632
Georgia MEDICAID 000663396F

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