Healthcare Provider Details

I. General information

NPI: 1386893634
Provider Name (Legal Business Name): ARTHUR ASHLEY DOUGHTY CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2008
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9320 US HIGHWAY 301 S
RIVERVIEW FL
33578-6300
US

IV. Provider business mailing address

PO BOX 650782
DALLAS TX
75265-0782
US

V. Phone/Fax

Practice location:
  • Phone: 813-471-0000
  • Fax: 656-233-5024
Mailing address:
  • Phone: 302-799-0806
  • Fax: 302-733-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN564451
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN9449889
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: