Individual provider · Type 1 NPI
Kevin Andrew Douglas, DPM
Foot & Ankle Surgery Podiatrist · Coram, NY
NPI number
1174020598
Active
Practice location
100 Middle Country Rd
Coram, NY 11727-4412
Fax (631) 696-9635
Mailing address
1000 Montauk Hwy
West Islip, NY 11795-4927
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| Foot & Ankle Surgery Podiatrist Primary | 213ES0103X | N007168 (NY) |
Foot & Ankle Surgery Podiatrist: Definition to come...
4 other providers at this address
About NPI 1174020598
Kevin Andrew Douglas, DPM's National Provider Identifier is 1174020598, issued on Apr 11, 2018. The primary taxonomy on file is Foot & Ankle Surgery Podiatrist (213ES0103X), and the practice location is in Coram, NY. The record was last updated on Jun 6, 2022.