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General NPI Number Information
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NPI Number | 1154894608
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Entity Type | Organization
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Legal Business Name | JOHN H MCDOUGALL OD PC
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Dates
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Enumeration Date | 01/08/2019
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Last Update Date | 09/09/2024
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Provider Practice Location Address
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Address Line | 2005 COURT ST
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City | BEATRICE
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State | NE
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Zip | 68310-3210
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Country | US
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Telephone | 402-420-2020
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Fax | 402-223-5286
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Provider Business Mailing Address
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Address Line | 111 E 4TH ST STE 440
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City | ALTON
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State | IL
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Zip | 62002-6206
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Country | US
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Telephone | 618-462-9818
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Fax | 314-741-4947
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Authorized Official
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Title or Position | CREDENTIALING CONTACT
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Name | MELISSA ALLISON
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Credential |
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Telephone | 314-741-8183
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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