Individual
RICHARD DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
3600 30TH ST, PRIMARY CARE, DES MOINES, IA 50310-5876
(515) 699-5999
Mailing address
3600 30TH ST, PRIMARY CARE, DES MOINES, IA 50310-5876
(515) 699-5999
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1582
IA
Other
Enumeration date
05/04/2006
Last updated
07/09/2010
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