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Individual

DR. JOHN H MCDOUGALL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
2445 BROADWAY ST, QUINCY, IL 62301-3257
(217) 222-8800
(217) 641-0028
Mailing address
2445 BROADWAY ST, QUINCY, IL 62301-3257
(217) 222-9207
(217) 222-9205

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
002541
IA
152W00000X
Optometrist
Primary
046006875
IL
152W00000X
Optometrist
T02383
MO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1780633008
IA
05
1780633008
IL
05
1780633008
MO
Enumeration date
05/06/2006
Last updated
02/23/2018
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