Active NPI
Douglas Eugene Outcalt, M.D.
- Public Health & General Preventive Medicine Physician
- Phoenix, AZ
National Provider Identifier
1093032286
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Public Health & General Preventive Medicine Physician
- License
- 13340
- Practice address
- 505 E. Van Buren
Phoenix, AZ 85004 - Phone
- (602) 827-2014
- Fax
- (602) 827-2221
- NPI assigned
- Apr 27, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 13340 | AZ | |
| Public Health & General Preventive Medicine Physician | 2083P0901X | 13340 | AZ | Primary |
Addresses
Primary practice location
505 E. Van Buren
Phoenix, AZ 85004
Mailing address
505 E. Van Buren
Phoenix, AZ 85004
Phone (602) 827-2014
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13340 | AZ | MD | Family Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1272326400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1272326400000",
"number": "1093032286",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "505 E. VAN BUREN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85004",
"telephone_number": "602-827-2014",
"fax_number": "602-827-2221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "505 E. VAN BUREN",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "85004",
"telephone_number": "602-827-2014",
"fax_number": "602-827-2221"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OUTCALT",
"first_name": "DOUGLAS",
"middle_name": "EUGENE",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-04-27",
"last_updated": "2010-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "AZ",
"license": "13340",
"primary": false
},
{
"code": "2083P0901X",
"taxonomy_group": "",
"desc": "Preventive Medicine, Public Health & General Preventive Medicine",
"state": "AZ",
"license": "13340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.