Individual
ELILLIAN J DAUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2615 E HIGH ST, SPRINGFIELD, OH 45505-1412
(937) 328-9456
Mailing address
PO BOX 5127, LIMA, OH 45802-5127
(419) 224-5707
(419) 229-0040
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35.069815
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0217429
—
OH
Enumeration date
03/10/2006
Last updated
07/08/2011
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