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Individual

DR. WILLIAM LADELL DOUGLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 E 20TH ST, SUITE B, HOPE, AR 71801-8213
(870) 777-2100
(870) 777-4851
Mailing address
100 E 20TH ST, SUITE B, HOPE, AR 71801-8213
(870) 777-2100
(870) 777-4851

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
R4535
AR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
124721001
AR
01
144850000
QUAL CHOICE
AR
01
5J306
BCBS
AR
Enumeration date
07/20/2006
Last updated
07/08/2007
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