Provider Demographics
NPI:1124629332
Name:PRINGLE, DOUGLAS SCOTT (PD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:SCOTT
Last Name:PRINGLE
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 SYLAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:AR
Mailing Address - Zip Code:72560-8607
Mailing Address - Country:US
Mailing Address - Phone:870-269-4295
Mailing Address - Fax:
Practice Address - Street 1:409 SYLAMORE AVE
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:AR
Practice Address - Zip Code:72560-8607
Practice Address - Country:US
Practice Address - Phone:870-269-4295
Practice Address - Fax:870-269-5501
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2020-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPD07271183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist