Healthcare Provider Details

I. General information

NPI: 1598727083
Provider Name (Legal Business Name): JAMES PATRICK DAUGHERTY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/03/2006
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1751 VETERANS DR STE 190
FLORENCE AL
35630-4930
US

IV. Provider business mailing address

PO BOX 18428
HUNTSVILLE AL
35804-8428
US

V. Phone/Fax

Practice location:
  • Phone: 256-760-0422
  • Fax: 256-284-6065
Mailing address:
  • Phone: 256-705-4224
  • Fax: 256-705-4135

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number10732
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: