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General NPI Number Information
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NPI Number | 1386600872
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Entity Type | Organization
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Legal Business Name | MACLAND LTD
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Dates
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Enumeration Date | 04/24/2006
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Last Update Date | 10/19/2007
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Provider Practice Location Address
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Address Line | 1525 N GENTRY CIR
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City | MESA
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State | AZ
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Zip | 85213-4001
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Country | US
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Telephone | 480-833-6010
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Fax |
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Provider Business Mailing Address
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Address Line | 1525 N GENTRY CIR
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City | MESA
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State | AZ
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Zip | 85213-4001
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Country | US
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Telephone | 480-833-6010
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. DANIEL C MACDOUGALL
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Credential | DR
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Telephone | 480-833-6010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 7047
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License Number State | AZ
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