Individual
MICHAEL DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-2538
(601) 815-1854
Mailing address
2500 NORTH STATE ST, JACKSON, MS 39216
(601) 984-2538
(601) 815-1854
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
13889
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119624
—
MS
05
—
180300
—
AL
01
—
300085749
RAILROAD MEDICARE
MS
01
—
512G700003
MS MEDICARE - GROUP
MS
01
—
DC7781
RAILROAD MEDICARE GROUP #
—
01
—
P00601123
RAILROAD MEDICARE
—
01
—
P01194855
RAILROAD MEDICARE PTAN
MS
Enumeration date
07/07/2006
Last updated
01/27/2016
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us