Fall, Douglas

Fall, Douglas is an individual health care provider with primary practice located at 4001 Carrick Dr Ste 160 , Medina OH 44256-5392. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Fall, Douglas can be contacted via phone (330) 723-7005.

Contact Information

Primary practice address
4001 Carrick Dr Ste 160 Medina OH 44256-5392
Phone: (330) 723-7005
Fax: (330) 723-4854
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 35073387F Ohio
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 35-073387 Ohio

Profile Details

NPI number 1205883899
LBN Legal business name Fall, Douglas
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 28th, 2006
Last updated Jul 26th, 2011 - about 13 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 1205883899 NPPES
Ohio MEDICAID 2315248
Ohio Other 942460636083

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