DR. MICHAEL L DOUGLAS (NPI# 1902169543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902169543 |
| Entity Type | Individual |
| Full Name | DR. MICHAEL L DOUGLAS |
| Credential | D.O. |
| Practice Address |
425 Bmh Physicians Office Bldg Maryville TN 37804 |
| Mailing Address |
103 W Broadway Ave Maryville TN 37801-4703 |
| Practice Telephone | 8659805260 |
| Practice Fax Number | 8659805261 |
| Mailing Telephone | 8652731752 |
| Mailing Fax Number | 8652731755 |
| Enumeration Date | 2012-06-19 |
| Last Update Date | 2019-09-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | TN0000003191 | TN | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Medical Center Dr, Ste 162, Stratford, NJ 080841500 | 8565466443 | |
| 800 Oak Ridge Tpke Ste A101, Oak Ridge, TN 378306927 | 8654831093 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437203544 | Michael Kirk Douglas | Counselor | 1303 Kent Avenue, Baltimore, MD 21207-4828 | 2007-01-23 |
| 1932296373 | Michael Douglas | Internal Medicine | 1920 Gunbarrel Rd, Suite 110, Chattanooga, TN 37421-3100 | 2006-10-06 |
| 1902907454 | Michael Lee Douglas | Family Medicine | 1110 Bergslien Street, Baldwin, WI 54002 | 2006-09-26 |
| 1407853088 | Michael L Douglas | Chiropractor | 4140 Nw 12th St, Lauderhill, FL 33313-5816 | 2005-06-28 |
| 1497246011 | Michael Douglas II | Case Manager/Care Coordinator | 2116 Justice St, Monroe, LA 71201-3618 | 2018-05-21 |
| 1639523665 | Michael Stephen Douglas | Anesthesiology | 11234 Anderson St, Department of Anesthesiology, Loma Linda, CA 92354 | 2016-04-15 |
| 1972908770 | Michael Douglas Jr. | Counselor | 1845 Grandstand Place, Elgin, IL 60123 | 2014-10-23 |
| 1841572856 | Michael Anthony Douglas | Counselor | 4760 Sepulveda Blvd, Culver City, CA 90230-4820 | 2011-09-15 |
| 1659679785 | Michael L Douglas | Counselor | 1523 N Boston Pl, Tulsa, OK 74106-4103 | 2011-03-14 |
| 1073736559 | Michael Adam Douglas | Psychologist | 11704 Wilshire Blvd, Suite 255, Los Angeles, CA 90025-1507 | 2007-04-11 |
| Street Address |
425 BMH PHYSICIANS OFFICE BLDG |
| City | MARYVILLE |
| State | TN |
| Zip Code | 37804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811996358 | James D Briggs | Urology | 425 Bmh Physicians Office Bldg, Maryville, TN 37804-5807 | 2005-07-18 |
| 1609148436 | Joshua Bryant Byrd | Urology | 425 Bmh Physicians Office Bldg, Maryville, TN 37804-5807 | 2012-02-09 |
| 1104099662 | Rebecca S Lavelle | Urology | 425 Bmh Physicians Office Bldg, Maryville, TN 37804 | 2008-04-04 |
| 1144285289 | Anthony L Tillman | Physician Assistant | 425 Bmh Physicians Office Bldg, Maryville, TN 37804-5807 | 2006-04-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659835825 | Matthew David Mallory | Physical Therapist | Morning View Village 2320 E. Lamar Alexander Parway, Maryville, TN 37804 | 2019-01-22 |
| 1063937290 | Rachel Ryan Mcmillan | Counselor | 362 High Street, Maryville, TN 37804 | 2017-08-09 |
| 1316461460 | Steven Casey Boring | Nurse Practitioner | 907 E. Lamar Alexander Pkwy., Maryville, TN 37804 | 2017-07-31 |
| 1851738751 | Robert Kane Mccall | Pathology | 250 E. Broadway, Maryville, TN 37804 | 2013-05-31 |
| 1619242849 | Jennifer Mcclements | Physical Therapy Assistant | 4004 Samuel Circle, Maryville, TN 37804 | 2012-03-21 |
| 1316223886 | Sabrina Nicole Powers | Social Worker | 1704 East Broadway, Maryville, TN 37804 | 2011-10-28 |
| 1407138381 | Russmann, Inc. | Ambulance | 4163 Benny Delozier Drive, Maryville, TN 37804 | 2011-09-15 |
| 1184932485 | Complete Family Care of Maryville, Pllc | Internal Medicine | 2004 E. Broadway, Maryville, TN 37804 | 2010-09-21 |
| 1093975096 | Kristi Clark Correll | Speech-Language Pathologist | 2030 East Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-12 |
| 1134388267 | Barbara Frantz Poulsen | Speech-Language Pathologist | 2030 E Lamar Alexander Parkway, Maryville, TN 37804 | 2008-06-04 |
| Find all providers in zip 37804 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881605509 | Tennessee Valley Urology PC | Urology | 103 Station Drive, Building 4, Maryville, TN 37804-4190 | 2006-08-10 |
| 1811996358 | James D Briggs | Urology | 425 Bmh Physicians Office Bldg, Maryville, TN 37804-5807 | 2005-07-18 |
| 1609148436 | Joshua Bryant Byrd | Urology | 425 Bmh Physicians Office Bldg, Maryville, TN 37804-5807 | 2012-02-09 |
| 1104099662 | Rebecca S Lavelle | Urology | 425 Bmh Physicians Office Bldg, Maryville, TN 37804 | 2008-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396363875 | Connor Forbes | Urology | Vumc Dept Urology, 1161 21st Ave. South, A-1302 Medical Center North, Nashville, TN 37232-2765 | 2020-07-10 |
| 1427528546 | Mark Johnson | Urology | 278 Franklin Rd Ste 150, Brentwood, TN 37027-3265 | 2018-12-01 |
| 1750808580 | Clyde Alexander Kyle | Urology | 448 Kyle Ln Nw, Cleveland, TN 37312-6435 | 2017-08-23 |
| 1316464142 | Urology Associates PC | Urology | 4601 Carothers Pkwy Ste 475, Franklin, TN 37067-5980 | 2017-08-23 |
| 1649796376 | Urology Associates PC | Urology | 502 Northcrest Dr, Springfield, TN 37172-4066 | 2017-08-15 |
| 1932625662 | Urology Associates PC | Urology | 393 Wallace Rd Ste A400, Nashville, TN 37211-4983 | 2017-08-15 |
| 1619493343 | Urology Associates PC | Urology | 5651 Frist Blvd Ste 616, Hermitage, TN 37076-2060 | 2017-08-15 |
| 1881110500 | Urology Associates PC | Urology | 107 Glen Oak Blvd Ste 100, Hendersonville, TN 37075-3161 | 2017-08-15 |
| 1124544853 | Urology Associates PC | Urology | 3443 Dickerson Pike Ste 160, Nashville, TN 37207-2533 | 2017-08-15 |
| 1801310727 | Urology Associates PC | Urology | 1909 Mallory Ln Ste 110, Franklin, TN 37067-8230 | 2017-08-01 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.