# J. TODD DOUGLAS, MD, PSC

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

## Provider details

- **NPI number:** 1427165869
- **Authorized official:** DR. JAMES TODD DOUGLAS MD (PRESIDENT/OWNER)
- **Authorized official phone:** (270) 526-2772

## Contact information

- **Practice address:** 205 E OHIO ST, MORGANTOWN, KY 42261-7944
- **Practice address phone:** (270) 526-2772
- **Practice address fax:** (270) 526-6323
- **Mailing address:** PO BOX 1367, 205 EAST OHIO ST, MORGANTOWN, KY 42261-1367
- **Mailing address phone:** (270) 526-2772
- **Mailing address fax:** (270) 526-6323

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 34188 | KY | Yes |
| 363LF0000X | Family Nurse Practitioner | 7100116510 | KY | — |

## Other

- **Enumeration date:** 08/23/2006
- **Last updated:** 01/18/2012