Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. JERRY EDWARD DOUGLAS, MD
ActiveDR. JERRY EDWARD DOUGLAS, MD is a Family Medicine healthcare provider located in CLEARLAKE, California. NPI 1285603621 is currently active in the NPPES registry. Verify at CMS.
Family Medicine · CLEARLAKE, CA
Registration Details
- NPI Number
- 1285603621
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 17, 2006 (20.22907767932 yrs)
- Last Updated
- Apr 2, 2018
- Licenses
-
01032101A (IN)C53653 (CA)53653 (CA)
Practice Information
- Address
-
15322 LAKESHORE DRSUITE 202CLEARLAKE, CA, 954229814Browse CA providers · Browse ZIP 95422
- Phone
- 7079940303
- Fax
- 7079959447
- Primary Specialty
-
Family Medicine
207Q00000X
- Additional Specialty
- Family Medicine
- Additional Specialty
- Family Medicine
Other Family Medicine Providers in CLEARLAKE, CA
| Name | Credential | NPI |
|---|---|---|
| DR. MARK J FREEMAN | MD | 1801898929 |
| DR. JOHN ALDEN WEEKS | M.D. | 1962473074 |
| WOLFGANG SCHUG | MD | 1598798233 |
| GAIL MARQUETTE | FNP | 1205851656 |
| SUSAN SALMINA | FNP-C | 1700322690 |
| SONJA DEROSE | MD | 1558849661 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.