Individual
SCOTT K DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1640 CRAWFORDSVILLE SQUARE DR, CRAWFORDSVILLE, IN 47933-3800
(765) 362-5789
(765) 362-2453
Mailing address
413 E JEFFERSON ST, CRAWFORDSVLLE, IN 47933-2929
(765) 366-2787
(765) 366-2787
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01037795
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100466830
—
IN
Enumeration date
06/01/2006
Last updated
05/10/2024
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