Individual
DR. DEREK BRADLEY DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
4234 ILLINOIS AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0035
Mailing address
4234 ILLINOIS AVE, FORT LEONARD WOOD, MO 65473-9098
(573) 596-0035
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2021020693
MO
Other
Enumeration date
02/26/2018
Last updated
05/14/2026
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