Individual
DR. DOUGLAS HAMILTON GAITHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5820 BELLE AVE, DAVENPORT, IA 52807-2782
(615) 516-4291
Mailing address
5280 BELLE AVE., DAVENPORT, IA 52807
(615) 516-4291
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036.126675
IL
207P00000X
Emergency Medicine Physician
11044
TN
207P00000X
Emergency Medicine Physician
38712
IA
207P00000X
Emergency Medicine Physician
44100
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036.126675
MEDICAL LICENSE NUMBER
IL
01
—
11044
MEDICAL LICENSE NUMBER
TN
01
—
2008425
BCBS
—
01
—
38712
MEDICAL LICENSE NUMBER
IA
01
—
44100
MEDICAL LICENSE NUMBER
CO
Enumeration date
08/09/2005
Last updated
05/16/2014
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