Individual
MR. MARK PAUL DOUGHTY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
314 GRANVILLE ST, NEWARK, OH 43055-4483
(740) 328-2228
(740) 349-2313
Mailing address
350 JEFFERSON RD, NEWARK, OH 43055-4539
(740) 366-5718
(740) 349-2313
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT-000004
OH
Other
Enumeration date
02/14/2006
Last updated
07/08/2007
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