Individual
DR. DOUGLAS J HART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
3950 CENTRAL AVE, MEMPHIS, TN 38111-7602
(901) 458-6291
(901) 323-4848
Mailing address
3950 CENTRAL AVE, MEMPHIS, TN 38111-7602
(901) 458-6291
(901) 323-4848
Taxonomy
Speciality
Code
Description
License number
State
103TA0700X
Adult Development & Aging Psychologist
P0000001092
TN
103TB0200X
Cognitive & Behavioral Psychologist
P0000001092
TN
103TC0700X
Clinical Psychologist
Primary
P0000001092
TN
103TC2200X
Clinical Child & Adolescent Psychologist
P0000001092
TN
103TF0000X
Family Psychologist
P0000001092
TN
103TM1800X
Intellectual & Developmental Disabilities Psychologist
P0000001092
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0044740
TN BLUE CROSS BLUE SHIELD
TN
01
—
59964
CIGNA
TN
Enumeration date
08/01/2005
Last updated
02/04/2008
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