Individual
DR. KIMBERLY MARK DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
3150 ROGERS RD STE 110, WAKE FOREST, NC 27587-4196
(919) 263-9163
(919) 263-9408
Mailing address
1004 KENNISON CT, ROLESVILLE, NC 27571-9009
(919) 368-4668
(919) 263-9408
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2257
NC
Other
Enumeration date
09/08/2009
Last updated
10/03/2024
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