Individual
DR. TIMOTHY TYLER DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1 BARNES JEWISH HOSPITAL PLZ, SAINT LOUIS, MO 63110-1003
(314) 362-8065
Mailing address
660 S EUCLID AVE # 8121, SAINT LOUIS, MO 63110-1010
(314) 362-8065
(314) 747-1080
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
2021020540
MO
Other
Enumeration date
08/03/2018
Last updated
06/18/2021
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