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Individual

DR. SHAWN PAUL DOHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
611 FRANKLIN ST, NATCHEZ, MS 39120-3311
(601) 445-4282
Mailing address
611 FRANKLIN ST, NATCHEZ, MS 39120-3311
(601) 445-4282
(601) 445-9197

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MS511
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00880060
MS
05
1466727
LA
01
410047920
RR MEDICARE
Enumeration date
10/26/2005
Last updated
04/22/2008
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