FREDERICK G DOUGLAS MD NPI 1922040955

NPI Information

  • NPI: 1922040955
  • Provider Name: FREDERICK G DOUGLAS, MD
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • Address: 106 JOHN STREET
    EASLEY, SC
    ZIP 29640
  • Phone: (864) 859-2220

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NPI Details

Frederick G Douglas, MD is a family medicine in Easley, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. Frederick G Douglas, MD NPI is 1922040955. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

106 JOHN STREET
EASLEY, SC
ZIP 29640-415
Phone: (864) 859-2220
Fax: (864) 859-5744

The enumeration date for this NPI number is 6/12/2006 and was last updated on 2/10/2010.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily Medicine5691SOUTH CAROLINAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1D908156202MEDICARE PINSOUTH CAROLINA
2056913MEDICAIDSOUTH CAROLINA
3D908159367MEDICARE PINSOUTH CAROLINA
4D90815MEDICARE UPINSOUTH CAROLINA
5582296052055OTHERSOUTH CAROLINABLUE CROSS
6134768MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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