Individual
JACOB WILLIAM MCDOUGALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
162 LEGACY OAKS DR, KNIGHTDALE, NC 27545-6556
(919) 373-1800
Mailing address
817 E GANNON AVE, SUITE #104, ZEBULON, NC 27597-9309
(919) 375-1975
(919) 269-0240
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0010-06933
NC
363A00000X
Physician Assistant
Primary
12689705-1206
UT
363AS0400X
Surgical Physician Assistant
12689705-8906
UT
Other
Enumeration date
01/05/2017
Last updated
10/26/2022
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