Douglas Santrell Banks, PROSTHETISTS
Individual provider Active NPI Prosthetist · Ridgeland, MS
NPI 1285848846 · NPPES record last updated Feb 10, 2014
Key facts
- NPI
- 1285848846
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Prosthetist 224P00000X
- License
- 224P00000X (MS)
- Practice address
- 199 Charmant PL
Suite 4
Ridgeland, MS 39157-4358 - Phone
- (601) 856-8360
- NPI assigned
- May 10, 2007
- 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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 224P00000X | MS | MD | Prosthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| United Care Prosthetics LLC | Prosthetist | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Prosthetist | 224P00000X | 224P00000X | MS | Yes |
Addresses
Primary practice location
199 Charmant PL
Suite 4
Ridgeland, MS 39157-4358
Mailing address
199 Charmant PL
Suite 4
Ridgeland, MS 39157-4358
Phone (601) 856-8360
Other providers in Ridgeland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 10, 2014. 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.