Michael Tyrone Douglas, M.S. A.T.C.
Specialist/Technologist, Athletic Trainer in Atlanta, GA. Individual provider (NPI-1).
NPI number1679535397
StatusActive
Last updated in NPPESJul 8, 2015
Details
- NPI
- 1679535397
- Entity type
- Individual (NPI-1)
- Name
- Mr. Michael Tyrone Douglas
- Credential
- M.S. A.T.C.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 6, 2006
- Last updated
- Jul 8, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2255A2300X | Specialist/Technologist, Athletic Trainer | AT001037 | GA | Yes |
Practice location
101 Marietta St NwAtlanta, GA 30303-2720
Phone 404-246-9770
Mailing address
152 Fulton Way SeAtlanta, GA 30312-2916
Phone 404-246-9770
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