Individual
MICHAEL SEAN DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
243 CURTISS RD STE 100, BARKSDALE AFB, LA 71110-2425
(318) 456-6884
Mailing address
243 CURTISS RD STE 100, BARKSDALE AFB, LA 71110-2425
(318) 456-6884
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/17/2019
Last updated
06/04/2020
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