Individual
MR. DOUGLAS FLOYD FACKLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
EVANSVILLE VA OUTPATIENT CLINIC, 500 E. WALNUT, EVANSVILLE, IN 47713
(812) 465-6202
(812) 465-6201
Mailing address
143 PENNYRILE DR, MADISONVILLE, KY 42431-9219
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA00512
TX
Other
Enumeration date
09/27/2006
Last updated
07/08/2007
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