Provider Demographics
NPI: | 1346671088 |
---|---|
Name: | NANCY J DUGGAR MD LLC |
Entity type: | Organization |
Organization Name: | NANCY J DUGGAR MD LLC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | PHYSICIAN |
Authorized Official - Prefix: | DR |
Authorized Official - First Name: | NANCY |
Authorized Official - Middle Name: | J |
Authorized Official - Last Name: | DUGGAR |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | MD |
Authorized Official - Phone: | 205-512-1200 |
Mailing Address - Street 1: | 1110 HIGHWAY 78 W |
Mailing Address - Street 2: | |
Mailing Address - City: | JASPER |
Mailing Address - State: | AL |
Mailing Address - Zip Code: | 35501-3657 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 205-512-1200 |
Mailing Address - Fax: | 205-384-4999 |
Practice Address - Street 1: | 1110 HIGHWAY 78 W |
Practice Address - Street 2: | |
Practice Address - City: | JASPER |
Practice Address - State: | AL |
Practice Address - Zip Code: | 35501-3657 |
Practice Address - Country: | US |
Practice Address - Phone: | 205-512-1200 |
Practice Address - Fax: | 205-384-4999 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2013-12-05 |
Last Update Date: | 2016-05-12 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
AL | 17417 | 207R00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Single Specialty |