Individual
SCOTT M DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2230 N RESERVE ST STE 402, MISSOULA, MT 59808-1364
(406) 721-0533
(406) 728-4463
Mailing address
2827 FORT MISSOULA RD, MISSOULA, MT 59804-7408
(406) 327-4585
(406) 327-4502
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-34654
MT
Other
Enumeration date
09/08/2014
Last updated
09/18/2023
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