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John T Douglas

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NPI Number Detailed Information

Provider Information:

Name: John T Douglas
Gender: M
Provider License Number If Given: ARNP324902

NPI Information:

NPI: 1407840911
Entity Type
(Individual or Organization):
1-ind
Enumeration Date: 9/12/2005

Last Update Date: 7/8/2007

Provider Business Mailing Address:

Address: 2729 SE 48TH AVE
Ocala, FL 34471
Phone Number: 3522665880
Fax Number:

Provider Business Practice Location Address:

Address: HIGHWAY 16
Palatka, FL 32178
Phone Number: 3863267850
Fax Number:

Provider Taxonomy:

Primary: 367500000X
Secondary (if any):
State: FL

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