Stagg, Douglas L
Stagg, Douglas L is an individual health care provider with primary practice located at 775 Pole Line Rd W Suite 101, Twin Falls ID 83301-5814. He recently has only one registered license in Allopathic & Osteopathic Physicians / Occupational Medicine, which is considered as his primary health care specialty. Stagg, Douglas L can be contacted via phone (208) 814-8100.Contact Information
Primary practice address
775 Pole Line Rd W Suite 101
Twin Falls ID 83301-5814
Phone: (208) 814-8100
Fax: (208) 814-8900
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Occupational Medicine | 2083X0100X | M3528 | Idaho |
Profile Details
| NPI number | 1619904638 |
|---|---|
| LBN Legal business name | Stagg, Douglas L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 26th, 2006 |
| Last updated | Sep 6th, 2012 - about 12 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 | 1619904638 | NPPES |
| Idaho | MEDICAID | 003949000 |
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