| Doctor Name: | MR. MARK A DOUGLAS |
| NPI Number: | 1033226923 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CTRS |
| License Number: | 26219 |
| Business Practice Address: | 2200 Fort Roots Dr North Little Rock, AR - 721141709 |
| Business Phone Number: | 5012573285 |
| Business Fax Number: | |
| Mailing Address: | 1500 S Taylor St, LITTLE ROCK |
| State: | AR |
| Postal Code: | 722042663 |
| Phone Number: | 5012573285 |
| Fax Number: | |
| NPI Enumeration Date: | 08/24/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225800000X |
| License Number: | 26219 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AR |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Recreation Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A recreation therapist uses recreational activities for intervention in some physical, social or emotional behavior to bring about a desired change in that behavior and promote the growth and development of the patient. |