Individual
SUE ANN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2001 SHAWNEE MISSION PKWY STE 130, MISSION WOODS, KS 66205-2060
(913) 228-2000
(855) 354-0963
Mailing address
2001 SHAWNEE MISSION PKWY STE 130, MISSION WOODS, KS 66205-2060
(913) 228-2000
(855) 354-0963
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
M7958
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194491002
—
TX
Enumeration date
06/14/2005
Last updated
04/01/2020
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