Basic Information
| Provider Information | |||||||||
| NPI: | 1518147354 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | DOUGALD MACARTHUR | ||||||||
| LastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 32 | ||||||||
| Address2: | |||||||||
| City: | ANDOVER | ||||||||
| State: | NH | ||||||||
| PostalCode: | 032160032 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037356060 | ||||||||
| FaxNumber: | 6037356070 | ||||||||
| Practice Location | |||||||||
| Address1: | 90 SWIFTWATER RD | ||||||||
| Address2: | |||||||||
| City: | WOODSVILLE | ||||||||
| State: | NH | ||||||||
| PostalCode: | 037851421 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6037473668 | ||||||||
| FaxNumber: | 6037473024 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/09/2007 | ||||||||
| LastUpdateDate: | 01/18/2008 | ||||||||
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| AuthorizedOfficialLastName: | MACARTHUR | ||||||||
| AuthorizedOfficialFirstName: | DOUGALD | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 6037473668 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DO | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 11511 | NH | Y | 193400000X SINGLE SPECIALTY GROUP | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 1008936 | 05 | VT | MEDICAID | 30233973 | 05 | NH | MEDICAID | 58803 | 01 | VT | ANTHEM | OTHER |