Douglas, David

Douglas, David is an individual health care provider with primary practice located at 755 Cowan Dr , Lebanon MO 65536-4629. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Douglas, David can be contacted via phone (417) 532-2805.

Contact Information

Primary practice address
755 Cowan Dr Lebanon MO 65536-4629
Phone: (417) 532-2805
Fax: (417) 532-2865
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 2004022171 Missouri

Profile Details

NPI number 1396760476
LBN Legal business name Douglas, David
Credentials P.A.C
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 12th, 2006
Last updated Nov 27th, 2023 - about last year

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 1396760476 NPPES
Missouri Other 202941 BC, HARTVILLE MEDICAL CEN
Missouri Other 202943 BC, HARTVILLE MEDICAL CEN
Missouri MEDICAID 220024481 BC, HARTVILLE MEDICAL CEN

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