Stagg, Douglas L

Stagg, Douglas L is an individual health care provider with primary practice located at 775 Pole Line Rd W Suite 101, Twin Falls ID 83301-5814. He recently has only one registered license in Allopathic & Osteopathic Physicians / Occupational Medicine, which is considered as his primary health care specialty. Stagg, Douglas L can be contacted via phone (208) 814-8100.

Contact Information

Primary practice address
775 Pole Line Rd W Suite 101 Twin Falls ID 83301-5814
Phone: (208) 814-8100
Fax: (208) 814-8900
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Occupational Medicine 2083X0100X M3528 Idaho

Profile Details

NPI number 1619904638
LBN Legal business name Stagg, Douglas L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 26th, 2006
Last updated Sep 6th, 2012 - about 14 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 1619904638 NPPES
Idaho MEDICAID 003949000

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