Dr. Douglass Eugene Martin
Psychologist Addiction Psychologist (Substance Use Disorder)
4013 Ne 57th Pl
Gladstone
, Missouri 64119-2268
Dr. Douglass Eugene Martin
Psychologist Addiction Psychologist (Substance Use Disorder)
4013 Ne 57th Pl
Gladstone
, Missouri 64119-2268
(816) 413-5305
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About
Features
Specialties
- Psychologist
- Addiction Psychologist (Substance Use Disorder)
Languages spoken
- English
Location
First Address
- Dr. Douglass Eugene Martin
- 4013 Ne 57th Pl
- Gladstone, MO
- Zip : 64119-2268
- Fax : (816) 413-5305
- Phone : (816) 536-1828
Second Address
- Dr. Douglass Eugene Martin
- 4013 Ne 57th Pl
- Gladstone, MO
- Zip : 64119-2268
- Fax : (816) 413-5305
- Phone : (816) 536-1828
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 102L00000X | Psychologist | PY000307 | MO |
| Y | 103T00000X | Psychologist | PY000307 | MO |
| N | 103TA0400X | Addiction Psychologist (Substance Use Disorder) | PY000307 | MO |
National Provider Identifier
| NPI | 1649357211 |
|---|---|
| Provider Name | Dr. Douglass Eugene Martin |
| First Address | Gladstone, MO 64119-2268 |
| Second Address | Gladstone, MO 64119-2268 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 01/11/2006 |
| Last Update Date | 20/01/2010 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 16469011 | BC/BS PROVIDER # (01) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.