Provider Demographics
NPI:1255416822
Name:DUGGER, DAVID LEON (MD,FAAP)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEON
Last Name:DUGGER
Suffix:
Gender:M
Credentials:MD,FAAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 GOVERNMENT ST
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3931
Mailing Address - Country:US
Mailing Address - Phone:228-818-2450
Mailing Address - Fax:228-818-2451
Practice Address - Street 1:1800 GOVERNMENT ST
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3931
Practice Address - Country:US
Practice Address - Phone:228-818-2450
Practice Address - Fax:228-818-2451
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2012-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS069092080P0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0006XAllopathic & Osteopathic PhysiciansPediatricsDevelopmental - Behavioral Pediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00116232Medicaid
MS00116232Medicaid