Maxwell, Douglas Courtney

Maxwell, Douglas Courtney is an individual health care provider with primary practice located at 2415 Andover Dr , Valdosta GA 31602-1280. He recently has 2 registered licenses in different health care specialties including Dental Providers / Dentist, Dental Providers / General Practice. Dental Providers / Dentist is his primary health care specialty. Maxwell, Douglas Courtney can be contacted via phone (229) 671-1900.

Contact Information

Primary practice address
2415 Andover Dr Valdosta GA 31602-1280
Phone: (229) 671-1900
Fax: (229) 671-1999
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 11562 Georgia
Dental Providers / General Practice 1223G0001X 11562 Georgia

Profile Details

NPI number 1205999133
LBN Legal business name Maxwell, Douglas Courtney
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 19th, 2006
Last updated Aug 1st, 2012 - 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1205999133 NPPES
Georgia Other 9183256 DORAL
Georgia MEDICAID 000963256A DORAL
Georgia Other 986622 DORAL
Georgia Other 100049 DORAL

Popular Providers