Individual
KATHLEEN C DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
802 NEW HOLLAND AVE, LANCASTER, PA 17602-2163
(717) 560-3782
(717) 560-3787
Mailing address
802 NEW HOLLAND AVE, LANCASTER, PA 17602-2163
(717) 560-3782
(717) 560-3787
Taxonomy
Speciality
Code
Description
License number
State
2084F0202X
Forensic Psychiatry Physician
MD041845L
PA
2084P0800X
Psychiatry Physician
MD041845L
PA
2084P0805X
Geriatric Psychiatry Physician
Primary
MD041845L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0012204570001
—
PA
05
—
0012204570005
—
PA
05
—
12204570004
—
PA
01
—
233185
VALUE OPTIONS
PA
01
—
50056697
CAPITAL BLUE CROSS
PA
01
—
621495
HIGHMARK BLUE SHIELD
PA
Enumeration date
03/30/2006
Last updated
08/19/2007
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