Individual
DR. JON HARRELL DOCHERTY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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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