Provider Demographics
NPI:1427002047
Name:DOUGLAS, BARBARA G (MD)
Entity Type:Individual
Prefix:DR
First Name:BARBARA
Middle Name:G
Last Name:DOUGLAS
Suffix:
Gender:F
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:PO BOX 10700
Mailing Address - Street 2:
Mailing Address - City:ST THOMAS
Mailing Address - State:VI
Mailing Address - Zip Code:00801-3700
Mailing Address - Country:US
Mailing Address - Phone:340-775-3700
Mailing Address - Fax:340-777-7927
Practice Address - Street 1:4605 TUTU PARK MALL
Practice Address - Street 2:SUITE 207
Practice Address - City:ST THOMAS
Practice Address - State:VI
Practice Address - Zip Code:00802-1736
Practice Address - Country:US
Practice Address - Phone:340-775-3700
Practice Address - Fax:340-777-7927
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2012-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VI1459207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC024534300Medicaid
86003OtherMAMSI
521422197001OtherCIGNA
05993OtherAMERIGROUP
42010001OtherBLUE CROSS BLUE SHIELD
455314OtherAETNA
455314OtherAETNA
05993OtherAMERIGROUP