Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 26259 | KY |
NPI | 1053416313 |
---|---|
Provider Name | Dr. Donald R. Douglas |
First Address | Nicholasville, KY 40356 |
Second Address | Lexington, KY 40503-3201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/09/2006 |
Last Update Date | 09/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000108104 | ANTHEM PIN (01) | KY |
164291501 | U. S. DOL (01) | |
2000319 | UNITED HEALTHCARE (01) | KY |
611369666 | HUMANA PIN (01) | KY |
64262595 | (05) | KY |
F14766 | (02) | KY |
F14766 | BLUEGRASS FAMILY HEALTH (01) | KY |