Mark Lee Douglas (NPI# 1306974464, PAC ID# 0941114631) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERNAL MEDICINE.
| Nation Provider ID (NPI) | 1306974464 |
| PAC ID by PECOS | 0941114631 |
| Professional Enrollment ID | I20120302000016 |
| Full Name | Mark Lee Douglas |
| Address |
5098 Washington St W Suite 408 Cross Lanes WV 25313-1561 |
| Phone Number | 3047765594 |
| Gender | M |
| Medical School | WEST VIRGINIA SCHOOL OF OSTEOPATHIC MEDICINE |
| Graduation Year | 1989 |
| Primary Specialty | INTERNAL MEDICINE |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 510022 | CHARLESTON AREA MEDICAL CENTER |
| 510029 | THOMAS MEMORIAL HOSPITAL |
| 510031 | ST FRANCIS HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 5098 Washington St W, Suite 408, Cross Lanes, WV 25313-1561 | 3047765594 |
| Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
|---|---|---|---|
| ACI_EC_TRANS_PPHI_1 | Security Risk Analysis | % |
| Street Address |
5098 WASHINGTON ST W SUITE 408 |
| City | CROSS LANES |
| State | WV |
| Zip | 25313-1561 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Victor P Salutillo | Family Medicine | 5392 Big Tyler Rd, Charleston, WV 25313-1059 | |
| Mark S Calfee | Chiropractic | 5390 Big Tyler Rd, Cross Lanes, WV 25313-1059 | |
| Gregory C Stonestreet | Family Medicine | 5508 Big Tyler Rd, Cross Lanes, WV 25313-1304 | |
| Megan Elizabeth Fernandez | Nurse Practitioner | Wv Primary Care Inc | 924 Cross Lanes Dr, Cross Lanes, WV 25313-1315 |
| Ashish Pramod Sheth | Internal Medicine | Wv Primary Care Inc | 924 Cross Lanes Dr, Cross Lanes, WV 25313-1315 |
| Rachel Lynn Campbell | Nurse Practitioner | Wv Primary Care Inc | 924 Cross Lanes Dr, Cross Lanes, WV 25313-1315 |
| Tammy L Franklin | Nurse Practitioner | Wv Primary Care Inc | 924 Cross Lanes Dr, Cross Lanes, WV 25313-1315 |
| Arvind Viradia | Internal Medicine | 117 Goff Mountain Rd, Cross Lanes, WV 25313-1434 | |
| Christy A Estep | Family Medicine | Womencare Inc | 5161 Washington St W, Cross Lanes, WV 25313-1535 |
| Amber Duncan | Nurse Practitioner | Womencare Inc | 5161 Washington St W, Cross Lanes, WV 25313-1535 |
| Find all physicians in zip 25313 | |||
| City | CROSS LANES |
| Zip Code | 25313 |
| Specialty | INTERNAL MEDICINE |
| City + Specialty | CROSS LANES + INTERNAL MEDICINE |
Please comment or provide details below to improve the information on Mark Lee Douglas.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.