# DOUGLAS MEDICAL GROUP, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346578861
- **Authorized official:** MS. JAMIE L WARNER (ASSISTANT MANAGER)
- **Authorized official phone:** (547) 957-3079

## Contact information

- **Practice address:** 1813 W HARVARD AVE, SUITES 110, 201, 422, 426, ROSEBURG, OR 97471-2752
- **Practice address phone:** (541) 957-3079
- **Practice address fax:** (541) 464-4641
- **Mailing address:** 1813 W HARVARD AVE, SUITE 448, ROSEBURG, OR 97471-2752
- **Mailing address phone:** (541) 957-3079
- **Mailing address fax:** (541) 464-4641

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 207R00000X | Internal Medicine Physician | — | NULL | — |
| 207R00000X | Internal Medicine Physician | — | — | — |
| 208000000X | Pediatrics Physician | — | NULL | — |
| 208000000X | Pediatrics Physician | — | — | — |
| 208D00000X | General Practice Physician | — | NULL | — |
| 208D00000X | General Practice Physician | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | — |
| 363L00000X | Nurse Practitioner | — | — | — |

## Other

- **Enumeration date:** 11/20/2009
- **Last updated:** 12/17/2009