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NPI Code Detail

MEDICARE: MR. JAMES HAROLD DOUGAL RN

MEDICARE:  MR. JAMES HAROLD DOUGAL  RN
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
1163W00000XRegistered Nurse28068712AIN
2146N00000XBasic Emergency Medical Technician0242619IN

General Provider Information

NPI Number : 1437263860
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAMES HAROLD DOUGAL RN
Provider Business Mailing Address
First Line : 9701 BRUSH COLLEGE RD
Second Line :
City : WOODBURN
State : IN
Zip : 46797-9770
Country : US
Telephone Number : 260-657-5663
Fax Number :
Provider Business Practice Location Address
First Line : 3840 NEW VISION DR
Second Line :
City : FORT WAYNE
State : IN
Zip : 46845-1708
Country : US
Telephone Number : 260-483-2422
Fax Number : 260-471-0788
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2006
Last Update Date : 09/11/2025

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