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General NPI Number Information
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NPI Number | 1124135793
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Entity Type | Individual
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Provider Name | JOHN MUNROE DOUGLAS JR. M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/23/2006
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Last Update Date | 01/12/2023
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Provider Practice Location Address
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Address Line | 661 N LAFAYETTE ST
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City | DENVER
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State | CO
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Zip | 80218-3609
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Country | US
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Telephone | 720-360-5399
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Fax |
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Provider Business Mailing Address
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Address Line | 661 N LAFAYETTE ST
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City | DENVER
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State | CO
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Zip | 80218-3609
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Country | US
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Telephone | 720-360-5399
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number | 057063
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License Number State | GA
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