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NPI Code Detail

MEDICARE: DR. ANTHONY CHRISTOPHER DOUGHERTY M.D.

MEDICARE: DR. ANTHONY CHRISTOPHER DOUGHERTY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician030452GA

General Provider Information

NPI Number : 1396741112
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ANTHONY CHRISTOPHER DOUGHERTY M.D.
Provider Business Mailing Address
First Line : 8051 CHAPEL LAKE DR
Second Line :
City : MIDLAND
State : GA
Zip : 31820-3527
Country : US
Telephone Number : 706-568-5000
Fax Number :
Provider Business Practice Location Address
First Line : 3000 SCHATULGA RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31907-3117
Country : US
Telephone Number : 706-568-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/27/2005
Last Update Date : 07/08/2007

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