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Organization

DAUGHERTY MEDICAL GROUP, INC PSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH ADCOCK (OFFICE MANAGER)
(513) 872-5793
Entity
Organization

Contact information

Practice address
2230 AUBURN AVE, CINCINNATI, OH 45219-2922
(513) 861-6610
(513) 872-5794
Mailing address
2230 AUBURN AVE, CINCINNATI, OH 45219-2922

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0146185
OH
05
4008
KY
Enumeration date
05/01/2007
Last updated
08/22/2020
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