Provider Demographics
NPI:1447283601
Name:ALTHOUSE, DOUGLAS J (MD)
Entity type:Individual
Prefix:DR
First Name:DOUGLAS
Middle Name:J
Last Name:ALTHOUSE
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 1:727 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MINDEN
Mailing Address - State:NE
Mailing Address - Zip Code:68959-1705
Mailing Address - Country:US
Mailing Address - Phone:308-832-3400
Mailing Address - Fax:308-832-3402
Practice Address - Street 1:727 E 1ST ST
Practice Address - Street 2:
Practice Address - City:MINDEN
Practice Address - State:NE
Practice Address - Zip Code:68959-1705
Practice Address - Country:US
Practice Address - Phone:308-832-3400
Practice Address - Fax:308-832-3402
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2014-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE22934207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine