Individual provider Active NPI

Gary L Doublestein, D.O.

  • Obstetrics & Gynecology Physician
  • Muskegon, MI
National Provider Identifier
1760445571
Registry record updated Dec 19, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101008100 Issued in MI
Practice address
1675 Leahy St Ste 201a
Muskegon, MI 49442-5542
Phone
(231) 672-6600
Fax
(231) 727-4444
NPI assigned
Apr 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101008100 MI Primary

Addresses

Primary practice location

1675 Leahy St Ste 201a
Muskegon, MI 49442-5542

Mailing address

PO Box 1847
Muskegon, MI 49443-1847
Phone (231) 672-6600

Other practice location 1

1700 Clinton St
Muskegon, MI 49442-5502
Phone (231) 726-3511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
5101008100MIMDObstetrics & Gynecology Physician

NPI Registry JSON

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

{
    "created_epoch": "1144713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545177600000",
    "number": "1760445571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1847",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494431847",
            "telephone_number": "231-672-6600",
            "fax_number": "231-728-4691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST STE 201A",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425542",
            "telephone_number": "231-672-6600",
            "fax_number": "231-727-4444"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Clinton St",
            "address_purpose": "LOCATION",
            "city": "Muskegon",
            "state": "MI",
            "postal_code": "494425502",
            "country_code": "US",
            "telephone_number": "231-726-3511",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOUBLESTEIN",
        "first_name": "GARY",
        "middle_name": "L",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-11",
        "last_updated": "2018-12-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101008100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2018; 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.