Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | 37427 | AZ |
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 37427 | AZ |
N | 207XX0801X | Orthopaedic Trauma Surgeon | 37427 | AZ |
NPI | 1285781401 |
---|---|
Provider Name | Dr. Doug Steven Clouse |
First Address | Phoenix, AZ 85082-4568 |
Second Address | Gilbert, AZ 85297-7318 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2007 |
Last Update Date | 29/04/2019 |