Individual
DR. KEVIN DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1307 STATE HWY K, O'FALLON, MO 63366
(636) 980-2721
Mailing address
11157 E MAYWOOD CT, EFFINGHAM, IL 62401-7429
(217) 821-0920
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2025023537
MO
Other
Enumeration date
07/03/2025
Last updated
07/03/2025
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