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Individual
DR. JOHN DAUGHERTY
Active
Individual
DR. JOHN DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C-5390
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1569
SCHUMACHER GR TSG ID
AR
01
—
16194-1
FAA
AR
01
—
5335127
AETNA
AR
Enumeration date
05/04/2006
Last updated
03/07/2023
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