Provider Demographics
NPI:1922566694
Name:ROBIN F MACDOUGALL, D.O., P.L.L.C.
Entity Type:Organization
Organization Name:ROBIN F MACDOUGALL, D.O., P.L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:FRED
Authorized Official - Last Name:MACDOUGALL
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:602-788-4200
Mailing Address - Street 1:PO BOX 10370
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85318-0370
Mailing Address - Country:US
Mailing Address - Phone:619-838-7975
Mailing Address - Fax:
Practice Address - Street 1:5533 E BELL RD STE 109
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-1256
Practice Address - Country:US
Practice Address - Phone:602-788-4200
Practice Address - Fax:623-547-6863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-12
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Single Specialty