Provider Demographics
NPI:1255357737
Name:NISBET, J DOUGLAS II (MD)
Entity type:Individual
Prefix:
First Name:J
Middle Name:DOUGLAS
Last Name:NISBET
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:JOHN
Other - Middle Name:DOUGLAS
Other - Last Name:NISBET
Other - Suffix:II
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:445 TOLL GATE RD
Mailing Address - Street 2:PRC AND CREDENTIALING
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02886-2759
Mailing Address - Country:US
Mailing Address - Phone:401-273-0641
Mailing Address - Fax:401-273-2919
Practice Address - Street 1:390 TOLL GATE RD STE 201
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4326
Practice Address - Country:US
Practice Address - Phone:401-738-8803
Practice Address - Fax:401-738-7658
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2025-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI6757207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology