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

Mr. David Douglas, PAC

Individual provider Physician Assistant · NPI 1396760476

Mr. David Douglas, PAC is a Physician Assistant in Lebanon, Missouri. Qualified in 2004, 22 years ago. Practices with Advocates for a Healthy Community Inc, a 56-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
22
Licensed in
MO
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

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Practice location Address checks out

755 Cowan Dr
Lebanon, MO 65536-4629
Phone: (417) 532-2805
Fax: (417) 532-2865
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 904 S Pine St, Richland, MO 65556-7393 — (573) 765-2956

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2004022171 (MO)

Record details

NPI number1396760476
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedJuly 12, 2006
Last updated in NPPESNovember 27, 2023
Certification dateNovember 27, 2023
Mailing addressPo Box 517, Marshfield, MO 65706-0517

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Advocates For A Healthy Community Inc — 56 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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