Douglas C Bankhead, MD
Individual provider Active NPI Anesthesiology Physician · Columbia, MO
NPI 1700896347 · NPPES record last updated Apr 18, 2019
Key facts
- NPI
- 1700896347
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Anesthesiology Physician 207L00000X
- License
- 2010029896 (MO)
- Practice address
- 1100 Virginia Avenue
Columbia, MO 65212-0001 - Phone
- (573) 882-2568
- Fax
- (573) 882-2226
- NPI assigned
- Aug 8, 2006
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1648811205 | UT | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jim Bradway MD PC | Anesthesiology | Past | Accepting new patients |
| Danny Cole LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 2010029896 | MO | Yes |
| Anesthesiology Physician | 207L00000X | 1648811205 | UT |
Addresses
Primary practice location
1100 Virginia Avenue
Columbia, MO 65212-0001
Mailing address
PO Box 843966
Kansas City, MO 64184-3966
Phone (573) 884-3300
Other providers in Columbia, MO
- Bamboo Nutrition, LLC
- Neha Bang
- Abdulai Bangura
- Megan Bania
- Linnea Banker
- Anthony Jason Banks
- Cara Ann Banning
- Michael John Banning
- Sagar Bansal
- Shweta Bansal
All providers in Columbia, MO · Anesthesiology Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 18, 2019. 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.