# CAROLINE LOTT DOUGLAS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1295061208
- **Gender:** F
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 005678 | GA | Yes |
| 363AS0400X | Surgical Physician Assistant | PA9105371 | FL | — |

## Other

- **Enumeration date:** 10/26/2009
- **Last updated:** 06/27/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 005678 | MEDICAL LICENSE | GA |
| 05 | — | 858523224F | — | GA |