Healthcare Provider Details

I. General information

NPI: 1528281748
Provider Name (Legal Business Name): DOUGLAS R VANHEEL PT/ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/10/2007
Last Update Date: 11/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2541 PASS RD SUITE F
BILOXI MS
39531-2106
US

IV. Provider business mailing address

10521 DOGWOOD DR
OCEAN SPRINGS MS
39565-8376
US

V. Phone/Fax

Practice location:
  • Phone: 228-388-1002
  • Fax: 228-388-1006
Mailing address:
  • Phone: 228-238-9039
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberPT3713
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License NumberAT0391
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPTH7331
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: