Douglas Medical Specialists

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

048490 Issued in GA

Legal business name

DOUGLAS MEDICAL SPECIALISTS

Practice address

805 N Liberty Street
Nicholls, GA 31554-5438

Phone

(912) 345-9997

Fax

(912) 345-9976

NPI assigned

Dec 8, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mrs. Marci Lynn Davis-Vickers, RN

Title

Practice Manager

Phone

(912) 384-3338

Specialties & licenses 1

Addresses

Tax ID family

Douglas Medical Specialist2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Douglas Medical Specialist

  • Internal Medicine Physician
  • Willacoochee, GA
  • NPI 1114114055
  NPD tax ID

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1323302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323302400000",
    "number": "1477821197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "805 N. LIBERTY ST",
            "city": "NICHOLLS",
            "state": "GA",
            "postal_code": "315545438",
            "telephone_number": "912-345-9997",
            "fax_number": "912-345-9976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "805 N LIBERTY STREET",
            "city": "NICHOLLS",
            "state": "GA",
            "postal_code": "315545438",
            "telephone_number": "912-345-9997",
            "fax_number": "912-345-9976"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DOUGLAS MEDICAL SPECIALISTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-12-08",
        "last_updated": "2011-12-08",
        "status": "A",
        "authorized_official_last_name": "DAVIS-VICKERS",
        "authorized_official_first_name": "MARCI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRACTICE MANAGER",
        "authorized_official_telephone_number": "912-384-3338",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "048490",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bacon County Health Services, Inc. (Nicholls Family Healthcare)
• Jose Ramon Castro, MD
• CRH Physician Practices LLC (CRH Nicholls Clinic)
• Jordyn Cheyenne Dedmond
• Amber Dowling, CRNA
• Latasha Nicole Gilliard, FNP-BC
• Healthstat on-Site Clinic/Milliken Alma
• Pamela C. Lee, APRN, BC
• Brad M Mobley, PHARMOCIST

• Internal Medicine Physician in Nicholls, GA
• Providers in Nicholls, GA by specialty
• Internal Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.