Individual
XAVIER DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1919 E THOMAS RD, PHOENIX, AZ 85016-7710
(602) 933-3033
(602) 933-4311
Mailing address
2108 E THOMAS RD STE 130, PHOENIX, AZ 85016-0008
(602) 933-3124
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
57.247348
OH
207Q00000X
Family Medicine Physician
Primary
66991
AZ
2080S0010X
Pediatric Sports Medicine Physician
66991
AZ
Other
Enumeration date
03/27/2019
Last updated
07/25/2024
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