Individual
DR. JOHN J DOUGHERTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1010 CARONDELET DR STE 220, KANSAS CITY, MO 64114-4822
(816) 941-1600
(816) 941-1699
Mailing address
1010 CARONDELET DR STE 220, KANSAS CITY, MO 64114-4822
(816) 941-1600
(816) 941-1699
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
104398
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
247956733
—
MO
Enumeration date
06/29/2006
Last updated
09/07/2010
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