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Individual

MARILYN A DOUGHERTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
12605 E 16TH AVE, AURORA, CO 80045-2545
(303) 449-3770
(303) 400-5051
Mailing address
P O BOX 110429, AURORA, CO 80042-0429

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
23203
CO

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01232032
CO
Enumeration date
10/19/2006
Last updated
10/01/2015
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