Healthcare Provider Details

I. General information

NPI: 1437150562
Provider Name (Legal Business Name): FLOYD ARTHUR DOUGHTY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 06/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 FIR ST
SAN DIEGO CA
92101-2327
US

IV. Provider business mailing address

300 FIR ST
SAN DIEGO CA
92101-2327
US

V. Phone/Fax

Practice location:
  • Phone: 619-446-1560
  • Fax: 619-446-1692
Mailing address:
  • Phone: 619-446-1560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License NumberG72804
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: