Tim Douglass

Primary specialty

Private VehicleTaxonomy code 347C00000X

License

RP410135 Issued in OH

Legal business name

TIM DOUGLASS

Practice address

14060 Vincent Rd
Mount Vernon, OH 43050-8283

Phone

(740) 485-8529

NPI assigned

Apr 22, 2015

Organization subpart

No

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

Authorized official

Name

Tim D Douglass

Title

Driver

Phone

(740) 485-8529

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1429660800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1429660800000",
    "number": "1679960124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14060 VINCENT RD",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430508283",
            "telephone_number": "740-485-8529"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14060 VINCENT RD",
            "city": "MOUNT VERNON",
            "state": "OH",
            "postal_code": "430508283",
            "telephone_number": "740-485-8529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TIM DOUGLASS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-22",
        "last_updated": "2015-04-22",
        "status": "A",
        "authorized_official_last_name": "DOUGLASS",
        "authorized_official_first_name": "TIM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DRIVER",
        "authorized_official_telephone_number": "740-485-8529"
    },
    "taxonomies": [
        {
            "code": "347C00000X",
            "taxonomy_group": "",
            "desc": "Private Vehicle",
            "state": "OH",
            "license": "RP410135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Private Vehicle in Mount Vernon, OH
• Providers in Mount Vernon, OH by specialty
• Private Vehicle in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2015; 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.