Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Daniel R Douglas, PA

Individual provider Physician Assistant · NPI 1457508806

Daniel R Douglas, PA is a Physician Assistant in Lawrenceville, Georgia. Qualified in 2007, 19 years ago. Practices with Resurgens, LLC, a 182-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
19
Licensed in
GA
In the registry since
2008
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

758 Old Norcross Rd Ste 100
Lawrenceville, GA 30046-3385
Phone: (770) 962-4300
Fax: (770) 339-7544
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 005875 (GA)

Record details

NPI number1457508806
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedAugust 27, 2008
Last updated in NPPESOctober 5, 2010
Mailing address758 Old Norcross Rd, Suite 100, Lawrenceville, GA 30046-3385

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2007 (19 years in practice)
Group practice Resurgens, Llc — 182 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations5 on file with Medicare

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