Individual
DANIEL MACDOUGALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
310 COUNTY ROAD 14, DEL NORTE, CO 81132-8719
(719) 657-2510
(719) 657-4106
Mailing address
310 COUNTY ROAD 14, DEL NORTE, CO 81132-8719
(719) 657-2510
(719) 657-4106
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
58318
CO
390200000X
Student in an Organized Health Care Education/Training Program
BP10050784
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
58318
CO LIC
CO
Enumeration date
06/05/2014
Last updated
07/10/2017
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