Basic Information
| Provider Information | |||||||||
| NPI: | 1124629332 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PRINGLE | ||||||||
| FirstName: | DOUGLAS | ||||||||
| MiddleName: | SCOTT | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | PD | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 409 SYLAMORE AVE | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN VIEW | ||||||||
| State: | AR | ||||||||
| PostalCode: | 725608607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702694295 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 409 SYLAMORE AVE | ||||||||
| Address2: | |||||||||
| City: | MOUNTAIN VIEW | ||||||||
| State: | AR | ||||||||
| PostalCode: | 725608607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702694295 | ||||||||
| FaxNumber: | 8702695501 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2020 | ||||||||
| LastUpdateDate: | 11/04/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/04/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PD07271 | AR | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.