William Ladell Douglas, MD
Individual provider Active NPI Pediatric Adolescent Medicine Physician · Hope, AR
NPI 1285654285 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1285654285
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Adolescent Medicine Physician 2080A0000X
- License
- R4535 (AR)
- Practice address
- 100 E 20TH St
Suite B
Hope, AR 71801-8213 - Phone
- (870) 777-2100
- Fax
- (870) 777-4851
- NPI assigned
- Jul 20, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R4535 | AR | MD | Pediatric Adolescent Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| W Ladell Douglas MD LTD | Adolescent Medicine | Current |
Accepting new patients |
Locations
100 E 20th St
Ste B
Hope, AR 71801
Phone (870) 777-2100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Adolescent Medicine Physician | 2080A0000X | R4535 | AR | Yes |
Addresses
Primary practice location
100 E 20TH St
Suite B
Hope, AR 71801-8213
Mailing address
100 E 20TH St
Suite B
Hope, AR 71801-8213
Phone (870) 777-2100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 144850000 | Other | AR | QUAL CHOICE |
| 124721001 | Medicaid | AR | |
| 5J306 | Other | AR | BCBS |
Other providers in Hope, AR
- Stacy Davis
- Dean S. Butler Hope Physical Therapy Center
- Jessica Renee Dearinger
- Tamara Deloach
- Laura R Douglas
- Dr. Lester Sitzes III
- Angela Kelli Durham
- Kristen Edwards
- Constance Elizabeth Ellis
- Emergency Staffing Solutions Northeast Inc
All providers in Hope, AR · Pediatric Adolescent Medicine Physician in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.