Provider Demographics
NPI:1649762592
Name:MAY, DOUGLAS JR (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:
Last Name:MAY
Suffix:JR
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:PO BOX 31298
Mailing Address - Street 2:
Mailing Address - City:FORT GREELY
Mailing Address - State:AK
Mailing Address - Zip Code:99731-1298
Mailing Address - Country:US
Mailing Address - Phone:814-321-3306
Mailing Address - Fax:
Practice Address - Street 1:655 E 5TH STREET
Practice Address - Street 2:
Practice Address - City:FORT GREELY
Practice Address - State:AK
Practice Address - Zip Code:99731
Practice Address - Country:US
Practice Address - Phone:907-873-4975
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MO2019047627207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program