Individual
DOUGLAS C DESPAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
311 W LINCOLN ST STE 200, BELLEVILLE, IL 62220-1902
(618) 234-2566
(618) 234-5650
Mailing address
311 W LINCOLN ST, SUITE 300, BELLEVILLE, IL 62220-1902
(618) 234-2566
(618) 234-5650
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036-082846
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1062714
UNITED HEALTHCARE/COMMERCIAL
—
01
—
128607
BLUE CROSS BLUE SHIELD
MO
01
—
166435
GROUP HEALTH PLAN
—
01
—
176990
HEALTHLINK
—
01
—
5553294
AETNA
—
01
—
569579688
BLUE CROSS BLUE SHIELD
IL
01
—
678480001
DMERC
—
01
—
80037661
RR MEDICARE
—
Enumeration date
08/18/2005
Last updated
12/16/2021
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