Individual
DR. JON HARRELL DOCHERTY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 E PALMETTO ST, FLORENCE, SC 29506
(843) 667-9414
(843) 667-1362
Mailing address
360 N IRBY ST, FLORENCE, SC 29501-2808
(843) 667-9414
(843) 667-1362
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
20811
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
208117
—
SC
01
—
AA85152293
MEDICARE ID-TYPE UNSPECIFIED
SC
Enumeration date
06/21/2006
Last updated
12/23/2019
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