Individual
DR. JOSEPH K DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
5025 SHATTUCK RD, SAGINAW, MI 48603
(989) 752-7121
(989) 752-6918
Mailing address
5025 SHATTUCK RD, SAGINAW, MI 48603-2823
(989) 752-7121
(989) 752-6918
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4901004056
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0994678
HEALTHPLUS OF MICHIGAN
MI
01
—
1871699314
MEDICARE GROUP
MI
05
—
4338380
—
MI
01
—
900G310840
BLUE CROSS BLUE SHIELD
MI
01
—
JD004056
BLUE CROSS BLUE SHIELD
MI
Enumeration date
08/03/2006
Last updated
05/25/2018
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