Individual
JERROLD RAY DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
36000 DARNALL LOOP, CARL R. DARNALL ARMY MEDICAL CENTER, FORT HOOD, TX 76544-4752
(254) 288-8025
Mailing address
36000 DARNALL LOOP, CARL R. DARNALL ARMY MEDICAL CENTER, FORT HOOD, TX 76544-4752
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/10/2011
Last updated
06/10/2011
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