Healthcare Provider Details

I. General information

NPI: 1750307708
Provider Name (Legal Business Name): GEORGE JACKSON DOUTHIT JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/14/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 S 4TH ST
GADSDEN AL
35901
US

IV. Provider business mailing address

507 S 4TH ST
GADSDEN AL
35901
US

V. Phone/Fax

Practice location:
  • Phone: 256-547-7417
  • Fax: 256-547-7414
Mailing address:
  • Phone: 256-547-7417
  • Fax: 256-547-7414

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number12722
License Number StateAL
# 2
Primary TaxonomyY
Taxonomy Code207XS0114X
TaxonomyAdult Reconstructive Orthopaedic Surgery Physician
License Number12722
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number12722
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: