| Doctor Name: | LAURIE EVANS DOUGLAS |
| NPI Number: | 1013173590 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | MD |
| License Number: | 2014-00894 |
| Business Practice Address: | 301 S 28th Ave Hattiesburg, MS - 394017233 |
| Business Phone Number: | 6012611700 |
| Business Fax Number: | 6012888290 |
| Mailing Address: | 415 S 28th Ave, HATTIESBURG |
| State: | MS |
| Postal Code: | 394017246 |
| Phone Number: | 6015795463 |
| Fax Number: | 6015795240 |
| NPI Enumeration Date: | 08/04/2008 |
| NPI Last Update Date: | 10/14/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 207RH0003X |
| License Number: | 2014-00894 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Internal Medicine |
| Taxonomy Specialization: | Hematology & Oncology |
| Taxonomy Definition: | An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |