Individual
JASON DOUGLAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3500 FRANCISCAN WAY STE 3A, MICHIGAN CITY, IN 46360-0033
(219) 861-8828
(219) 861-8827
Mailing address
7895 GRAND BLVD, HOBART, IN 46342-6665
(219) 947-1910
(219) 947-3117
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036150263
IL
208600000X
Surgery Physician
4301101431
MI
Other
Enumeration date
07/10/2012
Last updated
07/31/2025
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