Individual
DR. MARK STEPHEN DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2080 CHILD ST, DEPARTMENT OF DERMATOLOGY - NAVAL HOSPITAL JACKSONVILLE, JACKSONVILLE, FL 32214-5005
(904) 542-7912
(904) 542-7917
Mailing address
700 S QUAIL CIR, ANAHEIM, CA 92807-4428
(904) 542-7912
(904) 542-7917
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
0101242719
VA
Other
Enumeration date
12/26/2006
Last updated
02/25/2025
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