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Organization
KATIE M. DOUGHERTY,D.O,P.C.
Active
Organization
KATIE M. DOUGHERTY,D.O,P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE FERGUSON (OFFICE MANAGER)
(215) 463-4363
Entity
Organization
Contact information
Practice address
2534 S 18TH ST, PHILADELPHIA, PA 19145-3701
(215) 463-4363
(215) 463-4365
Mailing address
2534 S 18TH ST, PHILADELPHIA, PA 19145-3701
(215) 463-4363
(215) 463-4365
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OS008476L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01589896
—
PA
Enumeration date
05/20/2008
Last updated
05/20/2008
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