DR. MARK STEPHEN DOUGLAS (NPI# 1649335118) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649335118 |
| Entity Type | Individual |
| Full Name | DR. MARK STEPHEN DOUGLAS |
| Credential | M.D. |
| Practice Address |
2080 Child St Department of Dermatology - Naval Hospital Jacksonville Jacksonville FL 32214-5005 |
| Mailing Address |
700 S Quail Cir Anaheim CA 92807-4428 |
| Practice Telephone | 9045427912 |
| Practice Fax Number | 9045427917 |
| Mailing Telephone | 9045427912 |
| Mailing Fax Number | 9045427917 |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2013-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207N00000X | Dermatology | 0101242719 | VA | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306974464 | Mark L Douglas | Internal Medicine | 5098 West Washington St, Ste 408, Cross Lanes, WV 25313-1419 | 2007-03-01 |
| 1144388398 | Mark S Douglas | Dentist | 4827 Laguna Park Dr, Suite 5, Elk Grove, CA 95758-5159 | 2006-12-04 |
| 1508475062 | Mark Douglas | Social Worker | 303 Fraser Dr, Hinesville, GA 31313-3712 | 2020-07-30 |
| 1033226923 | Mark A Douglas | Recreation Therapist | 2200 Fort Roots Dr, North Little Rock, AR 72114-1709 | 2006-08-24 |
| 1326050410 | Mark A Douglas | Emergency Medicine | 1 Medical Center Drive, Biddeford, ME 04005 | 2006-08-13 |
| 1679576516 | Mark Jason Douglas | Ophthalmology | 2880 Dauphin St, Mobile, AL 36606-2457 | 2005-05-24 |
| Street Address |
2080 CHILD ST DEPARTMENT OF DERMATOLOGY - NAVAL HOSPITAL JACKSONVILLE |
| City | JACKSONVILLE |
| State | FL |
| Zip Code | 32214-5005 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205836202 | Juan Pedro Rivera | Psychiatry & Neurology | 2080 Child St, Jacksonville, FL 32214-5005 | 2005-08-01 |
| 1477169662 | Bobby Joe Neal Kimbro | General Practice | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-09-22 |
| 1659986529 | Henry Lee Simmons Jr. | Pharmacist | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-09-09 |
| 1982228441 | Chantel Charais | Nurse Practitioner | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-06-01 |
| 1598388936 | Joseph Royer | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-20 |
| 1780206359 | Devin Alan Rickard | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-17 |
| 1881216307 | Adam Dillon Ratcliff | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-07 |
| 1619598588 | Sarah Chilson | Nurse Practitioner | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-05-02 |
| 1942820360 | Gregory Hay | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-04-27 |
| 1568083996 | Aaron Hancock | Student in an Organized Health Care Education/Training Program | 2080 Child St, Jacksonville, FL 32214-5005 | 2020-04-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699255653 | Natalia Rosa Terreros | Nurse Practitioner | 2080 Childs Street, Jacksonville, FL 32214 | 2018-08-20 |
| 1841586120 | Travis Christopher Allemang | Urology | 2080 Child St Dept 5000, Jacksonville, FL 32214 | 2011-06-24 |
| 1730169202 | Quinn Steven Bastian | Psychologist | 2080 Child Street, Mental Health Dept - Bldg 2034 / Nh Jax, Jacksonville, FL 32214 | 2006-01-19 |
| 1760753982 | Jennifer Marie Brooks | Registered Nurse | 2080 Child Street, Jacksonville, FL 32214 | 2012-01-19 |
| 1114298338 | Louis Humberto Grass IIi | Registered Nurse | 2080 Child Street, Anesthesia Dept, Jacksonville, FL 32214 | 2012-01-19 |
| 1851685713 | John Manning Lydon | Obstetrics & Gynecology | 2080 Child Street, Jacksonville, FL 32214 | 2011-06-07 |
| 1093865693 | Elisha Yvette Hansack | Pharmacist | 2080 Child Street, Jacksonville, FL 32214 | 2007-01-12 |
| 1073544466 | Ren-chang Liu | Radiology | 2080 Child Street, Jacksonville, FL 32214 | 2006-07-05 |
| 1598795742 | Beverly B. Nysewander | Nurse Practitioner | 2080 Child Street, Internal Medicine, Jacksonville, FL 32214 | 2006-07-04 |
| 1841823606 | Christine Due Higgins | Midwife | Naval Hospital Jacksonville 2089 Child St, Jacksonville, FL 32214-0001 | 2020-02-19 |
| Find all providers in zip 32214 | ||||
| Taxonomy Code | 207N00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source] Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/ Board certification is provided by the American Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902291784 | Brandon Tyler Beal | Dermatology | 6817 Southpoint Pkwy Ste 101, Jacksonville, FL 32216-6285 | 2015-03-30 |
| 1194079988 | Intracoastal Dermatology, Pllc | Dermatology | 4776 Hodges Blvd Ste 105, Jacksonville, FL 32224-7218 | 2012-11-01 |
| 1780861781 | Jacksonville Skin Cancer Center, P.a. | Dermatology | 4465 Baymeadows Rd Ste 5, Jacksonville, FL 32217-4727 | 2008-01-22 |
| 1720272644 | John Morello | Dermatology | 13111 Atlantic Blvd., Ste 4, Jacksonville, FL 32225 | 2007-09-04 |
| 1982740775 | Michael Edward Lutz | Dermatology | 4465 Baymeadows Rd, Suite 5, Jacksonville, FL 32217 | 2007-01-29 |
| 1386757540 | Joy R Boyne | Dermatology | 6869 Belfort Oaks Pl, Jacksonville, FL 32216-6242 | 2006-08-15 |
| 1124063391 | Robert Alan Baker | Dermatology | 11701-32 San Jose Blvd, Suite 216, Jacksonville, FL 32223 | 2006-06-19 |
| 1770521163 | James W Trimble | Dermatology | 6890 Belfort Oaks Pl, Jacksonville, FL 32216-6241 | 2006-06-04 |
| 1497709778 | Daniel J Abraham | Dermatology | 215b Station St, Jacksonville, NC 28546-6304 | 2006-05-20 |
| 1124076492 | Michael A. Gromet | Dermatology | 10036 Scott Mill Rd, Jacksonville, FL 32257-5885 | 2006-05-05 |
| Find all providers in JACKSONVILLE | ||||
| City | JACKSONVILLE |
| Zip Code | 32214 |
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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.