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

Jack Douglas

Individual provider Physical Therapist · NPI 1508054404

Jack Douglas is a Physical Therapist in Monticello, Mississippi. Practices as a sole proprietor. Licensed in Mississippi.

Licensed in
MS
In the registry since
2007

Practice location Address checks out

1065 E Broad St
Monticello, MS 39654-7703
Phone: (601) 587-7115
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT3353 (MS)

Record details

NPI number1508054404
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedOctober 5, 2007
Last updated in NPPESApril 7, 2010
Mailing address4109 Highway 98 W, Summit, MS 39666-9132

Other providers in Monticello