Smith, Douglas R
Smith, Douglas R is an individual health care provider with primary practice located at 122 12Th Street Ext , Princeton WV 24740-2352. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Smith, Douglas R can be contacted via phone (304) 487-7275.Contact Information
Primary practice address
122 12Th Street Ext
Princeton WV 24740-2352
Phone: (304) 487-7275
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PENDING | West Virginia |
Profile Details
| NPI number | 1114023942 |
|---|---|
| LBN Legal business name | Smith, Douglas R |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 16th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114023942 | NPPES |
| West Virginia | MEDICAID | PENDING |
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