Mckeag, Douglas Bruce
Mckeag, Douglas Bruce is an sole proprietor health care provider with primary practice located at 4411 Sw Vermont St , Portland OR 97219-1020. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Mckeag, Douglas Bruce can be contacted via phone (503) 494-9992.Contact Information
Primary practice address
4411 Sw Vermont St
Portland OR 97219-1020
Phone: (503) 494-9992
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Sports Medicine | 207QS0010X | MD167303 | Oregon |
Profile Details
| NPI number | 1871558353 |
|---|---|
| LBN Legal business name | Mckeag, Douglas Bruce |
| Credentials | MD, MS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 19th, 2006 |
| Last updated | Jul 25th, 2014 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1871558353 | NPPES |
| Indiana | MEDICAID | 200259190 | |
| Indiana | Other | P00800740 |
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