MEDICARE: WILLIAM ROY DUGDALE M.D

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	207Q00000X	Family Medicine Physician	G11043	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	011721675	OTHER	CA	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1992784235
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	WILLIAM ROY DUGDALE M.D

Provider Business Mailing Address
First Line	:	809 WIMBLEDON CT
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95864-6137
Country	:	US
Telephone Number	:	916-971-1253
Fax Number	:	916-486-0841

Provider Business Practice Location Address
First Line	:	809 WIMBLEDON CT
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95864-6137
Country	:	US
Telephone Number	:	916-971-1253
Fax Number	:	916-486-0841

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

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	04/04/2012

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Directions to “ WILLIAM ROY DUGDALE M.D” Practice Location

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