Jack Douglas, - Physical Therapist in Monticello, MS

Jack Douglas, is a Physical Therapist based in Monticello, Mississippi. Jack Douglas is licensed to practice in Mississippi (license number PT3353) and his current practice location is 1065 E Broad St, Monticello, Mississippi. He can be reached at his office (for appointments etc.) via phone at (601) 587-7115.

NPI number for Jack Douglas is 1508054404 and his current mailing address is 4109 Highway 98 W, Summit, Mississippi. He does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1508054404.

Contact Information

Jack Douglas,
1065 E Broad St,
Monticello, MS 39654-7703
(601) 587-7115
Not Available

Map and Direction




Healthcare Provider's Profile

Full NameJack Douglas
GenderMale
SpecialityPhysical Therapist
Location1065 E Broad St, Monticello, Mississippi
Accepts Medicare AssignmentsDoes not participate in Medicare Program. He may not accept medicare assignment.
  NPI Data:
  • NPI Number: 1508054404
  • Provider Enumeration Date: 10/05/2007
  • Last Update Date: 04/07/2010

Medical Identifiers

Medical identifiers for Jack Douglas such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1508054404NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist PT3353 (Mississippi)Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jack Douglas is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Jack Douglas,
4109 Highway 98 W,
Summit, MS 39666-9132

Ph: () -
Jack Douglas,
1065 E Broad St,
Monticello, MS 39654-7703

Ph: (601) 587-7115

Reviews and Comments


Physical Therapist in Monticello, MS

Kim Lewis,
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1065 E Broad St, Monticello, MS 39654
Phone: 601-587-1165    
Armanda L. Bourne, PT
Physical Therapist
Medicare: Medicare Enrolled
Practice Location: 314 Main St Ste C, Monticello, MS 39654
Phone: 601-587-2563    Fax: 601-587-0472

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.