Provider Demographics
NPI:1750473062
Name:MCCAUGHEY, RICHARD S (DO)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:S
Last Name:MCCAUGHEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1301 PENNSYLVANIA AVE STE 416
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50316-2367
Mailing Address - Country:US
Mailing Address - Phone:515-263-2300
Mailing Address - Fax:515-263-2303
Practice Address - Street 1:1301 PENNSYLVANIA AVE STE 416
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50316-2367
Practice Address - Country:US
Practice Address - Phone:515-263-2300
Practice Address - Fax:515-263-2303
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA19582083X0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083X0100XAllopathic & Osteopathic PhysiciansPreventive MedicineOccupational Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAA02067Medicare UPIN