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Individual

JONATHAN SAMUEL MCDOUGAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
75 FRANCIS ST, BOSTON, MA 02115-6106
(501) 733-1981
Mailing address
75 FRANCIS ST, BOSTON, MA 02115-6106

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
14216229-1205
UT
2085R0202X
Diagnostic Radiology Physician
Primary
292149
MA
2085R0202X
Diagnostic Radiology Physician
MD217707
OR
2085R0202X
Diagnostic Radiology Physician
V5103
TX
390200000X
Student in an Organized Health Care Education/Training Program
2020015334
MO
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
04/26/2017
Last updated
02/27/2026
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