Provider Demographics
NPI:1669679031
Name:DEUSSING, DOUGLAS V (DPT)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:V
Last Name:DEUSSING
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11621 ROBIOUS RD
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23113-2349
Mailing Address - Country:US
Mailing Address - Phone:804-794-7587
Mailing Address - Fax:804-794-4560
Practice Address - Street 1:11621 ROBIOUS RD
Practice Address - Street 2:
Practice Address - City:MIDLOTHIAN
Practice Address - State:VA
Practice Address - Zip Code:23113-2349
Practice Address - Country:US
Practice Address - Phone:804-794-7587
Practice Address - Fax:804-794-4560
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305205070225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA014874R74Medicare PIN