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NPI Code Detail

MEDICARE: DOUGLAS E RIMMER JR. M.D.

MEDICARE: DOUGLAS E RIMMER JR. M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology Physician021631LA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MD.021631OTHERLASTATE LICENSE

General Provider Information

NPI Number : 1386634590
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOUGLAS E RIMMER JR. M.D.
Provider Business Mailing Address
First Line : 3217 MABEL ST
Second Line :
City : SHREVEPORT
State : LA
Zip : 71103-4022
Country : US
Telephone Number : 318-631-9121
Fax Number : 318-631-9126
Provider Business Practice Location Address
First Line : 2400 HOSPITAL DR STE 370
Second Line :
City : BOSSIER CITY
State : LA
Zip : 71111-2391
Country : US
Telephone Number : 318-631-9121
Fax Number : 318-549-0240
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/27/2005
Last Update Date : 08/12/2022

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