Provider Demographics
NPI:1316627110
Name:W LADELL DOUGLAS MD LTD
Entity type:Organization
Organization Name:W LADELL DOUGLAS MD LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:LADELL
Authorized Official - Last Name:DOUGLAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:870-777-2100
Mailing Address - Street 1:100 E 20TH ST STE B
Mailing Address - Street 2:
Mailing Address - City:HOPE
Mailing Address - State:AR
Mailing Address - Zip Code:71801-8222
Mailing Address - Country:US
Mailing Address - Phone:870-777-2100
Mailing Address - Fax:870-777-4851
Practice Address - Street 1:100 E 20TH ST STE B
Practice Address - Street 2:
Practice Address - City:HOPE
Practice Address - State:AR
Practice Address - Zip Code:71801-8222
Practice Address - Country:US
Practice Address - Phone:870-777-2100
Practice Address - Fax:870-777-4851
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-18
Last Update Date:2023-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty