Individual
SUMNER B DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
401 BAPTIST DR STE 1040, MADISON, MS 39110-2009
(601) 605-2383
(601) 605-3898
Mailing address
965 RIDGE LAKE BLVD STE 103, MEMPHIS, TN 38120-9446
(901) 226-1613
(901) 227-8591
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
903149
MS
Other
Enumeration date
06/24/2019
Last updated
09/25/2020
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