Organization
J. TODD DOUGLAS, MD, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES TODD DOUGLAS MD (PRESIDENT/OWNER)
(270) 526-2772
Entity
Organization
Contact information
Practice address
205 E OHIO ST, MORGANTOWN, KY 42261-7944
(270) 526-2772
(270) 526-6323
Mailing address
PO BOX 1367, 205 EAST OHIO ST, MORGANTOWN, KY 42261-1367
(270) 526-2772
(270) 526-6323
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34188
KY
363LF0000X
Family Nurse Practitioner
7100116510
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64341886
—
KY
05
—
65903239
—
KY
Enumeration date
08/23/2006
Last updated
01/18/2012
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