Individual
DR. DONALD STEVEN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
624 HOSPITAL DR, PATHOLOGY DEPT, MOUNTAIN HOME, AR 72653-2955
(870) 425-5233
(870) 424-8455
Mailing address
PO BOX 310, MOUNTAIN HOME, AR 72654-0310
(870) 425-5233
(870) 424-8455
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
C4442
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161027001
—
AR
01
—
220023532
RAILROAD MEDICARE
AR
Enumeration date
08/19/2006
Last updated
01/29/2020
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