Healthcare Provider Details

I. General information

NPI: 1043252505
Provider Name (Legal Business Name): EDWARD PAYSON DAUGHERTY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/11/2006
Last Update Date: 07/09/2025
Certification Date: 07/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 NARROWS PKWY SUITE 110
BIRMINGHAM AL
35242-8637
US

IV. Provider business mailing address

15582 HIGHWAY 280 STE 106
CHELSEA AL
35043-8361
US

V. Phone/Fax

Practice location:
  • Phone: 205-444-9550
  • Fax: 205-314-3360
Mailing address:
  • Phone: 205-678-3924
  • Fax: 205-678-3383

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO408
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: