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General NPI Number Information
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NPI Number | 1124357439
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Entity Type | Organization
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Legal Business Name | DOUG S CLOUSE MD PLC
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Dates
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Enumeration Date | 12/15/2009
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 2450 S GILBERT RD STE 109
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City | CHANDLER
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State | AZ
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Zip | 85286-1594
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Country | US
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Telephone | 480-899-4333
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Fax | 480-899-7219
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Provider Business Mailing Address
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Address Line | 2450 S GILBERT RD STE 109
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City | CHANDLER
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State | AZ
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Zip | 85286-1594
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Country | US
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Telephone | 480-899-4333
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Fax | 480-899-7219
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Authorized Official
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Title or Position | OWNER
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Name | DR. DOUGLAS S CLOUSE
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Credential | MD
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Telephone | 480-899-2101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 37427
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License Number State | AZ
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