MEDICARE: WILLIAM MCDOUGALL DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	D024746	OR
2	207R00000X	Internal Medicine Physician	20A7843	CA
3	207R00000X	Internal Medicine Physician	DO24746	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598763302
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM MCDOUGALL DO

Provider Business Mailing Address
First Line	:	PO BOX 5299
Second Line	:
City	:	BROOKINGS
State	:	OR
Zip	:	97415-0102
Country	:	US
Telephone Number	:	541-813-1797
Fax Number	:	541-813-1801

Provider Business Practice Location Address
First Line	:	503 RAILROAD ST
Second Line	:
City	:	BROOKINGS
State	:	OR
Zip	:	97415-9043
Country	:	US
Telephone Number	:	707-954-8661
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	02/18/2021

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Directions to “ WILLIAM MCDOUGALL DO” Practice Location

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