Robert Eugene McDougle, LPTA
Individual provider Active NPI Physical Therapy Assistant · Shell Knob, MO
NPI 1902178106 · NPPES record last updated Feb 2, 2012
Key facts
- NPI
- 1902178106
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 116059 (MO)
- Practice address
- 22865 Countyline Rd
Shell Knob, MO 65747-7503 - Phone
- (417) 858-2421
- NPI assigned
- Feb 2, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 116059 | MO | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 116059 | MO | Yes |
Addresses
Primary practice location
22865 Countyline Rd
Shell Knob, MO 65747-7503
Mailing address
22865 Countyline Rd
Shell Knob, MO 65747-7503
Phone (417) 858-2421
Other providers in Shell Knob, MO
- Patrick B. Harr
- Jillian A Hodge
- Brian K. Leach
- Lester E Cox Medical Centers
- Lester E. Cox Medical Centers
- Mercy Clinic-Springfield Communities
- Mercy Hospital Springfield
- Randy King Miller
- Michelle Gail O'Connell
- Ozarks Regions Health Systems
All providers in Shell Knob, MO · Physical Therapy Assistant in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 2, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.