Organization
DR. SEAN DOUGHERTY, DPM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN M DOUGHERTY DPM (OWNER)
(707) 426-5644
Entity
Organization
Contact information
Practice address
1620 PENNSYLVANIA AVE STE A, FAIRFIELD, CA 94533-3509
(707) 426-5644
(707) 426-3156
Mailing address
1620 PENNSYLVANIA AVE STE A, FAIRFIELD, CA 94533-3509
(707) 426-5644
(707) 426-3156
Taxonomy
Speciality
Code
Description
License number
State
261QP1100X
Podiatric Clinic/Center
Primary
—
—
Other
Enumeration date
09/17/2020
Last updated
09/17/2020
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