Individual
CONNOR PATRICK DOHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, ATC
Contact information
Practice address
3400 LAFAYETTE RD STE 200, INDIANAPOLIS, IN 46222-1147
(317) 291-7422
(317) 291-7433
Mailing address
3400 LAFAYETTE RD STE 200, INDIANAPOLIS, IN 46222-1147
(317) 291-7422
(317) 291-7433
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
096004117
IL
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/25/2019
Last updated
04/03/2026
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