Healthcare Provider Details

I. General information

NPI: 1427002047
Provider Name (Legal Business Name): BARBARA G DOUGLAS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 08/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4605 TUTU PARK MALL SUITE 207
ST THOMAS VI
00802-1736
US

IV. Provider business mailing address

PO BOX 10700
ST THOMAS VI
00801-3700
US

V. Phone/Fax

Practice location:
  • Phone: 340-775-3700
  • Fax: 340-777-7927
Mailing address:
  • Phone: 340-775-3700
  • Fax: 340-777-7927

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number1459
License Number StateVI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: