Individual
JOE DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MAINE, SUITE A, LAWRENCE, KS 66044-1368
(785) 843-9192
(785) 856-9191
Mailing address
200 MAINE, SUITE A, LAWRENCE, KS 66044-1368
(785) 843-9192
(785) 856-9191
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0417815
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100097940A
—
KS
Enumeration date
01/30/2006
Last updated
05/23/2018
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