Individual
DR. DOUGLAS W ROOKSTOOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1701 S CREASY LN, LAFAYETTE, IN 47905-4972
(765) 502-4000
(765) 502-4709
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
01046778A
IN
208M00000X
Hospitalist Physician
Primary
01046778A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200093580
—
IN
01
—
P00465475
RR MEDICARE
IN
Enumeration date
08/10/2005
Last updated
10/23/2023
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