Individual
DR. MAXWELL JAMES DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3269 N STOCKTON HILL RD, KINGMAN, AZ 86409-3619
(928) 757-2101
Mailing address
3806 HEATHER AVE, KINGMAN, AZ 86401-3843
(715) 209-0132
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
R80416
AZ
390200000X
Student in an Organized Health Care Education/Training Program
Primary
R80416
AZ
Other
Enumeration date
05/25/2023
Last updated
05/23/2025
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