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NPI Code Detail

MEDICARE: DR. DOUGLAS LEE GOLLEHON M.D.

MEDICARE: DR. DOUGLAS LEE GOLLEHON 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
1207XX0005XSports Medicine (Orthopaedic Surgery) Physician29277NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14393368OTHERAETNA PPO
22429303OTHERUNITED HEALTHCARE
32077885OTHERFIRST HEALTH
436164OTHERBCBS
5MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
62354647OTHERAETNA HMO

General Provider Information

NPI Number : 1639143845
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS LEE GOLLEHON M.D.
Provider Business Mailing Address
First Line : 1120 SE CARY PKWY
Second Line : SUITE 100
City : CARY
State : NC
Zip : 27518-7413
Country : US
Telephone Number : 919-467-4992
Fax Number : 919-481-9607
Provider Business Practice Location Address
First Line : 1120 SE CARY PKWY
Second Line : SUITE 100
City : CARY
State : NC
Zip : 27518-7413
Country : US
Telephone Number : 919-467-4992
Fax Number : 919-481-9607
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/14/2006
Last Update Date : 02/03/2011

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