Individual
RAY SCOTT DAUGHERTY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7777 HENNESSY BLVD STE 206, BATON ROUGE, LA 70808-4363
(225) 767-1156
(225) 767-5980
Mailing address
5959 S SHERWOOD FOREST BLVD, BATON ROUGE, LA 70816-6038
(225) 526-0001
(225) 765-9196
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
205766
LA
208600000X
Surgery Physician
54562
TN
208C00000X
Colon & Rectal Surgery Physician
Primary
205766
LA
208C00000X
Colon & Rectal Surgery Physician
54562
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08603276
—
MS
05
—
216071001
—
AR
01
—
6082717
BCBS
TN
05
—
Q023627
—
TN
Enumeration date
03/19/2010
Last updated
04/18/2018
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