Individual
LORI LYNN DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3721 HIGHWAY 412 E STE B, SILOAM SPRINGS, AR 72761-8010
(479) 215-3080
Mailing address
3510 RICHMOND RD, SUITE C, TEXARKANA, TX 75503-0714
(903) 831-3033
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E-14396
AR
Other
Enumeration date
09/30/2008
Last updated
09/14/2021
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