Individual
DR. AMY LYNN DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
2817 NEW PINERY RD, PORTAGE, WI 53901-9240
(608) 742-4131
Mailing address
2817 NEW PINERY RD, PORTAGE, WI 53901-9240
(608) 742-4131
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036.137970
IL
207Q00000X
Family Medicine Physician
125.062322
IL
207Q00000X
Family Medicine Physician
Primary
65068-21
WI
Other
Enumeration date
06/29/2012
Last updated
06/28/2016
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