Individual
DR. DANIELLE R DOUCET
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
775 POLE LINE RD W STE 213, TWIN FALLS, ID 83301-5820
(208) 818-8475
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
00063730
CO
2086S0129X
Vascular Surgery Physician
257280
MA
2086S0129X
Vascular Surgery Physician
Primary
MC-1427
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110097332A
—
MA
Enumeration date
10/22/2008
Last updated
08/01/2022
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