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1356312482
RONALD JASON DOUGLAS
FORT WAYNE, IN
NPI
1356312482
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: IN 10000680A)
Enumeration Date
2006-01-27
Last Update Date
2014-11-17
Business Address
Mr. RONALD JASON DOUGLAS PA
5001 US HIGHWAY 30 W STE D
FORT WAYNE, IN 46818-9701
Phone number: 260-432-1568
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Mailing Address
Mr. RONALD JASON DOUGLAS PA
PO BOX 80070
FORT WAYNE, IN 46898-0070
Phone number: 260-432-1568
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