MEDICARE: SAGE ALEXIS DOUGLAS

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
1	176B00000X	Midwife

General Provider Information

NPI Number	:	1508798851
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAGE ALEXIS DOUGLAS

Provider Business Mailing Address
First Line	:	7108 HONEYSUCKLE DR
Second Line	:
City	:	SEBRING
State	:	FL
Zip	:	33876-6124
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5920 FOREST PARK RD
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75235-6411
Country	:	US
Telephone Number	:	214-358-9031
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/01/2026
Last Update Date	:	06/01/2026

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Directions to “ SAGE ALEXIS DOUGLAS ” Practice Location

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