MONTE DOUGLAS


Address: 1400 Braden St, Jacksonville, AR 72076-3721
Phone: 5012411676

MONTE DOUGLAS (NPI# 1154736262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1154736262
Entity Type Individual
Full Name MONTE DOUGLAS
Credential PA-C
Practice Address 1400 Braden St
Jacksonville
AR 72076-3721
Mailing Address Po Box 497
Augusta
AR 72006-0497
Practice Telephone 5012411676
Practice Fax Number 5012411427
Mailing Telephone 8703472534
Mailing Fax Number 8703473492
Enumeration Date 2014-06-26
Last Update Date 2019-04-15
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363A00000X Physician Assistant PA-547 AR Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
2 Saint Vincent Cir, Little Rock, AR 722055423 5015523000

Office Location

Street Address 1400 BRADEN ST
City JACKSONVILLE
State AR
Zip Code 72076-3721

Providers in the same location

NPI Name Taxonomy Address Enumeration
1174509673 Pulaski Emergency Group LLC Physician Assistant 1400 Braden St, Jacksonville, AR 72076-3721 2005-12-16
1306476957 David Wicker Nurse Practitioner 1400 Braden St, Jacksonville, AR 72076-3721 2020-01-23
1689130338 Freedom Behavioral Hospital of Central Arkansas LLC Psychiatric Hospital 1400 Braden St, Jacksonville, AR 72076-3721 2019-02-19
1568715910 Chg Cornerstone Hospital of Little Rock, LLC Long Term Care Hospital 1400 Braden St, Jacksonville, AR 72076-3721 2012-10-23
1376812487 Gpn Jacksonville LLC Emergency Medicine 1400 Braden St, Er Dept, Jacksonville, AR 72076-3721 2011-12-19
1093044166 Jacksonville Emergency Medicine LLC Emergency Medicine 1400 Braden St, Jacksonville, AR 72076-3721 2009-12-18
1134367022 Rita Margaret Odom Nurse Practitioner 1400 Braden St, Jacksonville, AR 72076-3721 2009-01-30
1972709418 Nasir Zareen Emergency Medicine 1400 Braden St, Jacksonville, AR 72076-3721 2007-06-22
1487863619 Allegiance Hospital of North Little Rock, LLC General Acute Care Hospital 1400 Braden St, Jacksonville, AR 72076-3721 2007-05-22
1487870283 Tammy M Copeland Registered Nurse 1400 Braden St, Jacksonville, AR 72076-3721 2007-04-18
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1598396046 Jennifer Michelle Price Licensed Practical Nurse 2400 West Main, Jacksonville, AR 72076 2020-02-03
1912464009 Stat Home Health - Cenark LLC Home Health 1410 Braden Street, Jacksonville, AR 72076 2019-02-25
1649797671 Caring Hearts Counseling, LLC Case Management 111 Marble Drive, Jacksonville, AR 72076 2017-08-30
1376071340 Anne Elizabeth Houtchens Speech-Language Pathologist 2701 Tp White Drive, Jacksonville, AR 72076 2017-06-02
1881140648 Jacksonville North Pulaski School District Local Education Agency (LEA) 1414 West Main, Jacksonville, AR 72076 2016-08-31
1134599772 Jeremiah Melson Fleeman Occupational Therapist 2701 Tpwhite Drive, Jacksonville, AR 72076 2015-09-25
1821424565 Kasey Michele Leeson Social Worker 2520 W. Main St., Jacksonville, AR 72076 2013-09-25
1407104052 Cesalie Deonne Wallace Nurse Practitioner 3000 North First Street, Jacksonville, AR 72076 2012-08-29
1952660995 Joshua Aaron Hill Case Manager/Care Coordinator 2126 N. 1st St Suite F, Jacksonville, AR 72076 2012-05-11
1396023156 Syreeta Tucker Case Manager/Care Coordinator 1109 Burman, Jacksonville, AR 72076 2011-07-28
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Taxonomy Information

Taxonomy Code 363A00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant

Taxonomy Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1831799527 Emily Vander Zee Physician Assistant 6680 Bennett Creek Dr Apt 213, Jacksonville, FL 32216-0018 2020-10-30
1245830314 Jonathan V Korah Physician Assistant 6650 Corporate Center Pkwy Apt 1108, Jacksonville, FL 32216-8725 2020-10-28
1255931473 Rachel Gavrielle Stahly Physician Assistant 11438 Emuness Rd, Jacksonville, FL 32218-4050 2020-10-27
1760099071 Laura Alexandra Ramos-heckman Physician Assistant 2014 Capistrano Dr, Jacksonville, FL 32224-3091 2020-09-30
1184230583 Julian Clouse Physician Assistant 9803 Creekfront Rd Apt 307, Jacksonville, FL 32256-8449 2020-09-21
1962016717 Stephanie Benton Gentry Physician Assistant 3179 Shadow Creek Rd, Jacksonville, FL 32226-2386 2020-08-31
1629689435 Monarch Mental Health Association Physician Assistant 5393 Roosevelt Blvd Ste 8, Jacksonville, FL 32210-8424 2020-08-14
1235749425 Nicole Lhommedieu Physician Assistant 3850 Marnie Pl, Jacksonville, FL 32223-3541 2020-08-03
1861002123 Naw-am Acio Daniels Physician Assistant 7467 Volley Dr N, Jacksonville, FL 32277-9368 2020-08-03
1750906640 Veronica Adriana Dediego Physician Assistant 915 W Monroe St Ste 300, Jacksonville, FL 32204-1177 2020-06-16
Find all providers in JACKSONVILLE

Competitor

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City JACKSONVILLE
Zip Code 72076

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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