Crater Lake Emergency Physicians Llc

NPI 1194134031 - Emergency Medicine - 207P00000X

NPI Details
NPI 1194134031
Enumeration Date 08/05/2014
Last Updated 06/02/2016
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name DOUGLAS J DOUGLAS
Position OFFICER
Phone (469) 401-2386
Fax
Practice Location
340 NW COMMERCE DR
LAKE CITY FL, 32055-4709, US
Phone (469) 401-2386
Fax
Business Location
13737 NOEL RD
STE 1600
DALLAS TX, 75240-1331, US
Phone (469) 401-2386
Fax (214) 712-2444
Toxanomy
Taxonomy Code 207P00000X
License State
License Number
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According to our database, Crater Lake Emergency Physicians Llc NPI is 1194134031, taxonomy code is 207P00000X Crater Lake Emergency Physicians Llc physically located at 340 Nw Commerce Dr, Lake City FL, 32055-4709. NPI Number 1033115704 has the healthcare provider type.

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1194134031 NPI number is provided on an as is basis without warranty of any kind. 1194134031 is maintained by the National Plan & Provider Enumeration System. The contents of Crater Lake Emergency Physicians Llc are for informational purposes only.