Individual
DR. DOUGLAS L GATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 W JACKSON ST, SUITE 100, CARBONDALE, IL 62901-1474
(618) 457-0404
(618) 457-6579
Mailing address
305 W JACKSON ST, SUITE 100, CARBONDALE, IL 62901-1474
(618) 457-0404
(618) 457-6579
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
036090833
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
027521
HEALTH ALLIANCE
IL
05
—
036090833
—
IL
01
—
235776
HARMONY HEALTH
IL
01
—
271450
HEALTHLINK
IL
01
—
3930184
BLUE CROSS BLUE SHIELD
IL
Enumeration date
09/14/2006
Last updated
05/14/2008
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