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:
Health care specialties
| Specialty | Code | License # | 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 9 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 | 1003808361 | NPPES |
| Georgia | MEDICAID | 00663396B | |
| Georgia | Other | 2498075 | |
| Georgia | Other | 912915 | |
| Georgia | MEDICAID | 000663396E | |
| Georgia | Other | 070014632 | |
| Georgia | MEDICAID | 000663396F |
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