Individual
JOHN D DOUGHERTY III
Active
Individual
JOHN D DOUGHERTY III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
41024
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
Z139672
PTAN
AZ
Enumeration date
06/13/2006
Last updated
06/04/2018
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