Basic Information
Provider Information
NPI: 1043250897
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MCARTHUR
FirstName: DOUGLAS
MiddleName: RAY
NamePrefix: DR.
NameSuffix:  
Credential: DDS,MS
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 320 N CAMERON ST
Address2:  
City: HILLSBOROUGH
State: NC
PostalCode: 272782121
CountryCode: US
TelephoneNumber: 9192860411
FaxNumber: 9194165965
Practice Location
Address1: 508 FULTON ST
Address2:  
City: DURHAM
State: NC
PostalCode: 277053875
CountryCode: US
TelephoneNumber: 9192860411
FaxNumber: 9194165965
Other Information
ProviderEnumerationDate: 06/08/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
1223P0700X3376NCY Dental ProvidersDentistProsthodontics

No ID Information.


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