Provider Demographics
NPI:1376511576
Name:EILAND, DOUG (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUG
Middle Name:
Last Name:EILAND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2029 HARBOUR WATCH CIR
Mailing Address - Street 2:
Mailing Address - City:TARPON SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:34689-2055
Mailing Address - Country:US
Mailing Address - Phone:727-938-5809
Mailing Address - Fax:727-938-1256
Practice Address - Street 1:2029 HARBOUR WATCH CIR
Practice Address - Street 2:
Practice Address - City:TARPON SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:34689-2055
Practice Address - Country:US
Practice Address - Phone:727-938-5809
Practice Address - Fax:727-938-1256
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-14
Last Update Date:2020-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMD0000019494174400000X
FLME475602085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No174400000XOther Service ProvidersSpecialist