Individual provider Active NPI

Thomas Arthur Douyard, D.M.D.

  • General Practice Dentistry
  • Childersburg, AL
National Provider Identifier
1649380775
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3413 Issued in AL
Practice address
33044 US Highway 280
Childersburg, AL 35044-1896
Phone
(256) 378-3322
Fax
(256) 378-5280
NPI assigned
Aug 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3413 AL Primary

Addresses

Primary practice location

33044 US Highway 280
Childersburg, AL 35044-1896

Mailing address

33044 US Highway 280
Childersburg, AL 35044-1896
Phone (256) 378-3322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160225001528 AL Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 2567767734

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3413ALMDPediatric Occupational Therapist

NPI Registry JSON

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

{
    "created_epoch": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649380775",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33044 US HIGHWAY 280",
            "city": "CHILDERSBURG",
            "state": "AL",
            "postal_code": "350441896",
            "telephone_number": "256-378-3322",
            "fax_number": "256-378-5280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33044 US HIGHWAY 280",
            "city": "CHILDERSBURG",
            "state": "AL",
            "postal_code": "350441896",
            "telephone_number": "256-378-3322",
            "fax_number": "256-378-5280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUYARD",
        "first_name": "THOMAS",
        "middle_name": "ARTHUR",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Childersburg, AL

Sources for this page

Verify at the official NPI Registry.