Individual
DR. JOHN W MCDONOUGH II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
410 DEWEY ST, WISCONSIN RAPIDS, WI 54495-8075
(715) 421-5257
Mailing address
1000 N OAK AVE, MARSHFIELD, WI 54449-5703
(715) 387-5511
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
19291
WI
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
19291
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30035800
—
WI
Enumeration date
08/26/2005
Last updated
04/12/2012
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