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NPI Code Detail

MEDICARE: DR. DEANA MCDOUGALL MD

MEDICARE: DR. DEANA MCDOUGALL MD
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
1390200000XStudent in an Organized Health Care Education/Training ProgramE20537AR

General Provider Information

NPI Number : 1821843541
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DEANA MCDOUGALL MD
Provider Business Mailing Address
First Line : 1125 N COLLEGE AVE
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-1908
Country : US
Telephone Number : 479-521-8260
Fax Number : 479-444-7820
Provider Business Practice Location Address
First Line : 1125 N COLLEGE AVE
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-1908
Country : US
Telephone Number : 479-521-8260
Fax Number : 479-444-7820
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/17/2024
Last Update Date : 05/26/2026

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Directions to “ DR. DEANA MCDOUGALL MD” Practice Location

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