Mckeag, Douglas Bruce

Mckeag, Douglas Bruce is an sole proprietor health care provider with primary practice located at 4411 Sw Vermont St , Portland OR 97219-1020. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Mckeag, Douglas Bruce can be contacted via phone (503) 494-9992.

Contact Information

Primary practice address
4411 Sw Vermont St Portland OR 97219-1020
Phone: (503) 494-9992
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207QS0010X MD167303 Oregon

Profile Details

NPI number 1871558353
LBN Legal business name Mckeag, Douglas Bruce
Credentials MD, MS
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 19th, 2006
Last updated Jul 25th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1871558353 NPPES
Indiana MEDICAID 200259190
Indiana Other P00800740

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