Individual
DR. DEREK DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
1 AUDUBON PLAZA DR, LOUISVILLE, KY 40217-1318
(502) 634-6767
(502) 634-6775
Mailing address
PO BOX 36218, LOUISVILLE, KY 40233-6218
(502) 634-6767
(502) 634-6775
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
036.156045
IL
207P00000X
Emergency Medicine Physician
35.128034
OH
207P00000X
Emergency Medicine Physician
Primary
54968
KY
208D00000X
General Practice Physician
128034
OH
Other
Enumeration date
03/10/2014
Last updated
08/10/2022
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