Individual
PAUL S DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
107 IMPERIAL BLVD, SUITE 5, HENDERSONVILLE, TN 37075
(615) 826-3111
(615) 826-3112
Mailing address
PO BOX 1734, HENDERSONVILLE, TN 37077-1734
(615) 826-3111
(615) 826-3112
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD11629
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1067920
CIGNA
—
01
—
4004046
BC
—
Enumeration date
12/18/2006
Last updated
07/08/2007
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