Organization
MARK L. DOUGLAS, DO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HILDA MAXWELL (OFFICE MANAGER)
(304) 776-5594
Entity
Organization
Contact information
Practice address
130 GOFF MOUNTAIN RD, STE 12, CROSS LANES, WV 25313-1419
(304) 776-5594
(304) 776-3521
Mailing address
130 GOFF MOUNTAIN RD, STE 12, CROSS LANES, WV 25313-1419
(304) 776-5594
(304) 776-3521
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
06/21/2007
Last updated
08/22/2020
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