Mr Kobie I Douglas, MD | |
1100 W 6th Ave, Gary, IN 46402-1711 | |
(219) 885-4264 | |
(219) 880-0182 |
Full Name | Mr Kobie I Douglas |
---|---|
Gender | Male |
Speciality | Psychiatry |
Experience | 24 Years |
Location | 1100 W 6th Ave, Gary, Indiana |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1497850663 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084P0800X | Psychiatry & Neurology - Psychiatry | 036-115467 (Illinois) | Secondary |
2084P0800X | Psychiatry & Neurology - Psychiatry | 01071030A (Indiana) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Southlake Community Mental Health Center Inc | 5991600355 | 39 |
Entity Name | Southlake Community Mental Health Center Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1821081290 PECOS PAC ID: 5991600355 Enrollment ID: O20031201000049 |
Entity Name | Porter-starke Services Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1689627598 PECOS PAC ID: 1951293554 Enrollment ID: O20040330000098 |
Entity Name | Northshore Health Centers Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1114257300 PECOS PAC ID: 5799671236 Enrollment ID: O20040827000220 |
Mailing Address | Practice Location Address |
---|---|
Mr Kobie I Douglas, MD 1100 W 6th Ave, Gary, IN 46402-1711 Ph: (219) 885-4264 | Mr Kobie I Douglas, MD 1100 W 6th Ave, Gary, IN 46402-1711 Ph: (219) 885-4264 |
Nezar Khatib, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 600 Grant St, Gary, IN 46402 Phone: 219-886-4000 | |
Dr. Kovilparambil Xavier Antony, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1100 W 6th Avenue, Gary, IN 46402 Phone: 219-885-4264 | |
Dr. Pamela V. Tran, M.D. Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1100 W 6th Ave, Gary, IN 46402 Phone: 219-885-4264 | |
Dr. Martha F. Hernandez, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 3787 Grant St, Gary, IN 46408 Phone: 219-981-4800 Fax: 219-981-4805 | |
Dr. Beatrice Alexandria Nelson Brewer, M.D. Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 4844 Broadway, Gary, IN 46408 Phone: 219-985-2760 | |
Mr. Muhammad Butt, MD Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 1100 W 6th Ave, Gary, IN 46402 Phone: 219-885-4264 Fax: 219-882-0962 |