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DOUGLAS MEDICAL SPECIALIST
NPI 1114114055
Internal Medicine in Willacoochee, GA

Active since September 25, 2007CLIA 11D1041689 · Certificate of Compliance
134 E FLEETWOOD AVE, WILLACOOCHEE, GA 31650(912) 384-3338(912) 383-6365 Get Directions Write a Review

NPPES record last updated: October 30, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Douglas Medical Specialist NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOUGLAS MEDICAL SPECIALIST (NPI 1114114055) is a healthcare organization registered as an internal medicine in Willacoochee, Georgia and active in the NPI registry since September 2007. The organization holds a CLIA Certificate of Compliance certificate valid through September 30, 2026 and lists Marshall G Tanner, Director, as its authorized official.

NPPES Registry Identity

NPI1114114055
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameDOUGLAS MEDICAL SPECIALIST
Location Address134 E FLEETWOOD AVEWillacoochee, GA 31650
Mailing Address134 E Fleetwood AveWillacoochee, GA 31650 · (912) 384-3338 · Fax (912) 383-6365
Phone(912) 384-3338
Fax(912) 383-6365
Organization SubpartNo
Authorized OfficialMarshall G TannerDirector · (912) 384-3338
Enumeration DateSeptember 25, 2007
Last NPPES UpdateOctober 30, 2007
✔ NPI 1114114055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in GA · 056658
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
134 E FLEETWOOD AVE, Willacoochee, GA 31650
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Other Identifiers 9

Other1750374294GA · Npi
Medicare UPINP28327
Other1326031865GA · Npi
Medicare UPING29391
Other1225021678GA · Npi
Other1891815924GA · Npi
Medicare UPINF23558
Medicare UPINI39987
Medicare UPINQ46706

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Compliance 11D1041689

Douglas Medical Specialists · Douglas, GA
Active · expires Sep 30, 2026
CLIA Number11D1041689
Laboratory TypePhysician Office
Certificate Effective DateOctober 1, 2024
Certificate Expiration DateSeptember 30, 2026
Laboratory DirectorJohn David Arnett
Laboratory Phone(912) 384-3338
Laboratory LocationDouglas Medical Specialists200 Doctors Drive, Suite N, Douglas, GA 31533
CLIA data matches this NPI record on: Name Phone
This certificate is issued to a laboratory after an inspection that finds the laboratory to be in compliance with all applicable CLIA requirements.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Medical Specialist's NPI number?

The NPI number for Douglas Medical Specialist is 1114114055. It was assigned to this organization in the NPPES registry on September 25, 2007.

Where is Douglas Medical Specialist located?

Douglas Medical Specialist is located at 134 E Fleetwood Ave, Willacoochee, GA 31650. The listed phone number is (912) 384-3338.

What is Douglas Medical Specialist's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Douglas Medical Specialist hold a CLIA laboratory certificate?

Yes. A Certificate of Compliance (number 11D1041689) is associated with this NPI, valid through September 30, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Douglas Medical Specialist was last updated on October 30, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.