Dr. Mark Stephen Douglas, M.D.
Dermatology in Jacksonville, FL. Individual provider (NPI-1).
NPI number1649335118
StatusActive
Last updated in NPPESFeb 25, 2025
Details
- NPI
- 1649335118
- Entity type
- Individual (NPI-1)
- Name
- Dr. Mark Stephen Douglas
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Dec 26, 2006
- Certification date
- Feb 25, 2025
- Last updated
- Feb 25, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207N00000X | Dermatology | 0101242719 | VA | Yes |
Practice location
2080 Child StDepartment Of Dermatology - Naval Hospital Jacksonville
Jacksonville, FL 32214-5005
Phone 904-542-7912 · Fax 904-542-7917
Mailing address
700 S Quail CirAnaheim, CA 92807-4428
Phone 904-542-7912 · Fax 904-542-7917
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