Organization
MARILYN DOUGHERTY MD., PC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARILYN DOUGHERTY M.D. (OWNER)
(303) 449-3770
Entity
Organization
Contact information
Practice address
385 BROADWAY ST, BOULDER, CO 80305-3344
(303) 449-3770
(303) 449-5383
Mailing address
385 BROADWAY ST, BOULDER, CO 80305-3344
(303) 449-3770
(303) 449-5383
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
23203
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01232032
—
CO
Enumeration date
08/10/2011
Last updated
09/19/2011
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