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1902307762
DEREK BRADLEY DOUGLAS
FORT LEONARD WOOD, MO
NPI
1902307762
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207P00000X Emergency Medicine
(Licence: MO 2021020693)
Enumeration Date
2018-02-26
Last Update Date
2022-05-10
Business Address
DR. DEREK BRADLEY DOUGLAS D.O.
4430 MISSOURI AVE
FORT LEONARD WOOD, MO 65473-9098
Phone number: 253-968-2997
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Mailing Address
DR. DEREK BRADLEY DOUGLAS D.O.
4430 MISSOURI AVE # 1267
FORT LEONARD WOOD, MO 65473-9098
Phone number:
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