MEDICARE: JESSICA SIOBHAN DOUGLAS PA-C

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	363A00000X	Physician Assistant

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1578996310
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JESSICA SIOBHAN DOUGLAS PA-C

Provider Business Mailing Address
First Line	:	2604 GRANGE HALL ROAD
Second Line	:
City	:	EGLON
State	:	WV
Zip	:	26716
Country	:	US
Telephone Number	:	304-735-3155
Fax Number	:

Provider Business Practice Location Address
First Line	:	2604 GRANGE HALL ROAD
Second Line	:
City	:	EGLON
State	:	WV
Zip	:	26716-0008
Country	:	US
Telephone Number	:	304-735-3155
Fax Number	:	304-735-3409

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

Provider Enumeration Date	:	08/15/2013
Last Update Date	:	05/03/2016

Similar Medicare Providers

1538277231 — PRESTON TAYLOR COMMUNITY HEALTH CENTERS, INCORPORATED
Practice Location Address:

2604 GRANGE HALL ROAD
EGLON, WV
26716-0008

Practice Phone: 304-735-3155
Practice Fax: 304-735-3409

1578549879 — ANDREW M FOY MD
Practice Location Address:

2604 GRANGE HALL ROAD
EGLON, WV
26716

Practice Phone: 304-735-3155
Practice Fax: 304-735-3409

1295071413 — JOLENA MICHELLE SLAUBAUGH
Practice Location Address:

3109 SENECA TRL
EGLON, WV
26716-8045

Practice Phone: 304-698-5999
Practice Fax:

1053922336 — TAMMY MICHELLE PARSONS
Practice Location Address:

636 MAPLE SPRING HWY
EGLON, WV
26716-8670

Practice Phone: 304-291-9066
Practice Fax:

1639770910 — MARY ELLEN DELANEY
Practice Location Address:

804 SLAUBAUGH RD
EGLON, WV
26716-8048

Practice Phone: 304-291-9066
Practice Fax:

1760088454 — EUGENIA BERNADINE CASSIDY
Practice Location Address:

213 BACHTEL LN APT A
EGLON, WV
26716-9733

Practice Phone: 301-616-5878
Practice Fax:

Directions to “ JESSICA SIOBHAN DOUGLAS PA-C” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.