MR. DAVID THOMAS DOUGLASS (NPI# 1417949678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417949678 |
| Entity Type | Individual |
| Full Name | MR. DAVID THOMAS DOUGLASS |
| Credential | OD |
| Practice Address |
955 Broadway Bangor ME 04401-2918 |
| Practice Telephone | 2079904388 |
| Practice Fax Number | 2079479241 |
| Mailing Telephone | 2079904388 |
| Mailing Fax Number | 2079479241 |
| Enumeration Date | 2005-08-15 |
| Last Update Date | 2014-12-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | OPT757 | ME | Eye and Vision Services Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| ME | 243540099 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649526195 | David Leonard Douglass | Pharmacist | 3362 S 3rd St, Memphis, TN 38109-2944 | 2012-08-01 |
| 1780624353 | David Kevin Douglass | Nurse Practitioner | 9352 Park West Blvd, Knoxville, TN 37923-4325 | 2006-06-08 |
| 1639145741 | David Douglass | Pediatrics | 66 Lake Concord Rd Ne, Cabarrus Pediatric Clinic, Concord, NC 28025-3057 | 2006-02-28 |
| Street Address |
955 BROADWAY |
| City | BANGOR |
| State | ME |
| Zip Code | 04401-2918 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467601872 | Northeast Eyecare, Inc. | Optometrist | 955 Broadway, Bangor, ME 04401 | 2008-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184222523 | Bj's Wholesale Club Inc. | Eyewear Supplier (Equipment, not the service) | 110 Longview Dr, Bangor, ME 04401 | 2020-10-16 |
| 1033737937 | Daniel John Phulman | Counselor | 202 Exchange Street, Bangor, ME 04401 | 2020-07-08 |
| 1770104358 | Elizabeth Sarah Caruson | Physician Assistant | 417 State Street Webber Medical Building, East St, Ste. 121, Bangor, ME 04401 | 2020-05-05 |
| 1053961300 | Erika Dean | Occupational Therapist | 84 Sylvan Rd., Bangor, ME 04401 | 2019-09-18 |
| 1942853635 | Wildworks Therapy, Pllc | Occupational Therapist | 123 Mt Hope Ave, Bangor, ME 04401 | 2019-07-22 |
| 1255999173 | Jessica Arbisi | Physician Assistant | 1 Northeast Drive, Bangor, ME 04401 | 2019-06-05 |
| 1699232041 | Ehab Khamis Elhefnawi | Anesthesiology | Emmc Anesthesia Professional Service, 489 State Street, Bangor, ME 04401 | 2019-02-21 |
| 1477028884 | Zvorufura Makura | Otolaryngology | 885 Union Street, Ste 145, Bangor, ME 04401 | 2018-10-11 |
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1992211338 | Debra J Mcintyre | Counselor | 157 Park Street, #5, Bangor, ME 04401 | 2017-12-21 |
| Find all providers in zip 04401 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255826541 | Lindsey M Fields | Optometrist | 955 Broadway Eye Center Northeast Dba Northeast Eyecare, Bangor, ME 04401 | 2018-06-28 |
| 1730564618 | Luke Cyr | Optometrist | 35 State Hospital Druve, Eye Clinic, Bangor, ME 04401 | 2015-07-21 |
| 1306272406 | Ethan Ranger Taylor | Optometrist | 824 Stillwater Avenue, Bangor, ME 04401-3614 | 2013-09-20 |
| 1871700039 | Linwood L Colson IIi Od | Optometrist | 24 Springer Dr, Bangor, ME 04401-3654 | 2007-05-17 |
| 1326136250 | Linwood L Colson IIi | Optometrist | 24 Springer Drive, Bangor, ME 04401-3654 | 2006-10-10 |
| 1336245745 | Mark Stephen Varnum | Optometrist | 11 Bangor Mall Boulevard, Bangor, ME 04401 | 2006-09-15 |
| 1528160025 | Charles A Civiello Jr. | Optometrist | 105 Forest Ave, Bangor, ME 04401-5316 | 2006-09-04 |
| 1821000258 | Virginia Gilmore | Optometrist | 663 Stillwater Ave, Bangor, ME 04401-3642 | 2006-08-13 |
| 1881633154 | Kathryn R Beveridge | Optometrist | 766 Stillwater Ave, Bangor, ME 04401-3616 | 2006-06-05 |
| 1649239526 | Mary Drummond-eck | Optometrist | 327 Blue Valley Dr, Bangor, PA 18013-1526 | 2006-03-21 |
| Find all providers in BANGOR | ||||
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| 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.