THOMAS G DOUGLAS (NPI# 1851686182) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1851686182 |
| Entity Type | Individual |
| Full Name | THOMAS G DOUGLAS |
| Credential | NP |
| Practice Address |
108 S Hickory St Mount Vernon MO 65712-1407 |
| Mailing Address |
2828 N National Ave Springfield MO 65803-4306 |
| Practice Telephone | 4174664110 |
| Practice Fax Number | 4174664255 |
| Mailing Telephone | 4178374000 |
| Mailing Fax Number | 4178754710 |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2011-06-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
2011016629 | MO | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023114071 | Thomas R Douglas | Dentist | 308 Gibbs Pond Rd, Nesconset, NY 11767-2200 | 2006-09-16 |
| 1336213883 | Thomas H Douglas | Urology | 1780 Medical Park Dr, Rock Hill, SC 29732-1194 | 2006-11-17 |
| 1154384634 | Thomas Joseph Douglas IIi | Orthopaedic Surgery | 75 Francis St, Dept of Orthopedic Surgery, Boston, MA 02115-6110 | 2006-04-07 |
| Street Address |
108 S HICKORY ST |
| City | MOUNT VERNON |
| State | MO |
| Zip Code | 65712-1407 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578550158 | Malinda K Kendrick | Nurse Practitioner | 108 S Hickory St, Mount Vernon, MO 65712-1407 | 2005-09-29 |
| 1285183822 | Lisa Mccoy | Nurse Practitioner | 108 S Hickory St, Mount Vernon, MO 65712-1407 | 2016-09-23 |
| 1568502631 | Sgoh Acquisition Inc | Clinic/Center | 108 S Hickory St, Mount Vernon, MO 65712-1407 | 2007-02-07 |
| 1265417331 | William Lewis Mckay | Family Medicine | 108 S Hickory St, Mount Vernon, MO 65712-1407 | 2005-12-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063992527 | Regional Services | Nurse Practitioner | 400 Mo-174, Mt Vernon, MO 65712 | 2018-08-15 |
| 1295044303 | Jeffrey Paul Leclair | Physician Assistant | 1011 South East Street, Mt. Vernon, MO 65712 | 2010-10-07 |
| 1912174327 | Three Rivers Hospice Inc | Hospice Care, Community Based | 631 N Spring Park Blvd, Mt Vernon, MO 65712 | 2008-05-14 |
| 1821274929 | Hearing Crafters of America Inc | Hearing Instrument Specialist | 708 E Mt Vernon Blvd, Mt Vernon, MO 65712 | 2008-01-18 |
| 1609957885 | Mount Vernon Eyecare Associates, LLC | Optometrist | 104 S Hickory, Mount Vernon, MO 65712 | 2006-10-17 |
| 1982700423 | Ronald E. Price | Dentist | 1050 Hayward Dr., Mt Vernon, MO 65712 | 2006-09-15 |
| 1144279829 | Mary Elisabeth Aslin | Speech-Language Pathologist | 600 N. Main, Missouri Rehabilitation Center, Mount Vernon, MO 65712 | 2006-05-09 |
| 1912986332 | Robert Gordon Mcafee | Psychiatry & Neurology | 600 N Main, Mount Vernon, MO 65712 | 2006-01-13 |
| 1477856805 | Eric Snow | Physical Therapist | 1600 S Hickory St, Mount Vernon, MO 65712 | 2010-12-07 |
| 1477567030 | Ricky Lavaughn Kime | Internal Medicine | 600 N Main St, Va Outpatient Clinic, Mount Venon, MO 65712 | 2006-07-28 |
| Find all providers in zip 65712 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421066 | Amantha Theodore | Nurse Practitioner | 531 E Lincoln Ave Apt 4n, Mount Vernon, NY 10552-3743 | 2020-09-15 |
| 1093320392 | Ryan Michael Winder | Nurse Practitioner | 615 A Ave Se, Mount Vernon, IA 52314-1532 | 2020-09-14 |
| 1154969103 | Sarah Jacqueline Lim-dwyer | Nurse Practitioner | 1400 East Kincaid Street, Mount Vernon, WA 98274-4127 | 2019-12-19 |
| 1306481056 | Julie Marie Forbes-laborde | Nurse Practitioner | 27 Beekman Ave Apt 2, Mount Vernon, NY 10553-1491 | 2019-11-15 |
| 1447819305 | Gladys E Aideyan | Nurse Practitioner | 130 Stuyvesant Plz, Mount Vernon, NY 10552-1413 | 2019-06-13 |
| 1417467929 | Shernette T Suer | Nurse Practitioner | 105 Stevens Ave Ste 506, Mount Vernon, NY 10550-2683 | 2017-10-10 |
| 1194254946 | Amy Haibel | Nurse Practitioner | 206 S Mulberry St Ste B, Mount Vernon, OH 43050-3331 | 2017-06-06 |
| 1699216697 | Diana Mcnear | Nurse Practitioner | 421 S 3rd Ave, Mount Vernon, NY 10550-4507 | 2017-03-10 |
| 1598200867 | Vivienne Iona Bartley | Nurse Practitioner | 115 Primrose Avenue, Mount Vernon, NY 10552 | 2016-12-22 |
| 1144772955 | Tahiesha Tolbert | Nurse Practitioner | 153 Stevens Ave Ste 4, Mount Vernon, NY 10550-2543 | 2016-10-27 |
| Find all providers in MOUNT VERNON | ||||
| City | MOUNT VERNON |
| Zip Code | 65712 |
Please comment or provide details below to improve the information on THOMAS G DOUGLAS.
| 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.