Individual
DR. CHRISTOPHER P DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1504 SE 28TH ST, BENTONVILLE, AR 72712-3988
(479) 273-1111
(479) 273-1255
Mailing address
1504 SE 28TH ST, BENTONVILLE, AR 72712-3988
(479) 273-1111
(479) 273-1255
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
2003014160
MO
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
E476114
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
161277002
—
AR
05
—
206074312
—
MO
Enumeration date
09/07/2005
Last updated
10/08/2009
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