Healthcare Provider Details

I. General information

NPI: 1376896381
Provider Name (Legal Business Name): DOUGLAS R DOXEY D.P.M. A.B.P.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/16/2012
Last Update Date: 01/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2321 PYRAMID WAY STE B
SPARKS NV
89431-8715
US

IV. Provider business mailing address

2321 PYRAMID WAY STE B
SPARKS NV
89431-8715
US

V. Phone/Fax

Practice location:
  • Phone: 775-331-1919
  • Fax:
Mailing address:
  • Phone: 775-527-8305
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number1301
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number1301
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: