Provider Demographics
NPI:1821045824
Name:LAFLAN, DOUGLAS M (MD)
Entity Type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:M
Last Name:LAFLAN
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:PO BOX 110
Mailing Address - Street 2:804 CHASE AVE
Mailing Address - City:CREIGHTON
Mailing Address - State:NE
Mailing Address - Zip Code:68729-0110
Mailing Address - Country:US
Mailing Address - Phone:402-358-5335
Mailing Address - Fax:402-358-3598
Practice Address - Street 1:804 CHASE AVE
Practice Address - Street 2:
Practice Address - City:CREIGHTON
Practice Address - State:NE
Practice Address - Zip Code:68729-0110
Practice Address - Country:US
Practice Address - Phone:402-358-5335
Practice Address - Fax:402-358-3598
Is Sole Proprietor?:No
Enumeration Date:2006-05-27
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE12187207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE01395OtherBCBS
NE47058005800Medicaid
B67559Medicare UPIN
NE0229900001Medicare NSC
NA1009001Medicare PIN