Provider Demographics
NPI:1689257214
Name:MCDOUGALL, RILEY (MD)
Entity Type:Individual
Prefix:
First Name:RILEY
Middle Name:
Last Name:MCDOUGALL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3838 N CAMPBELL AVE
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85719-1454
Mailing Address - Country:US
Mailing Address - Phone:520-694-0861
Mailing Address - Fax:520-694-9276
Practice Address - Street 1:3838 N CAMPBELL AVE
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85719-1454
Practice Address - Country:US
Practice Address - Phone:520-694-0861
Practice Address - Fax:520-694-9276
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR78643207R00000X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine