Individual
DOUGLAS J STATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
209 MCNEEL LN, NORTH PLATTE, NE 69101-6054
(308) 534-8383
(308) 534-5670
Mailing address
904 HENRY AVENUE, NORTH PLATTE, NE 69101
(308) 532-5866
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19182
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025295700
—
NE
Enumeration date
06/14/2006
Last updated
11/17/2009
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