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General NPI Number Information
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NPI Number | 1104848241
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Entity Type | Individual
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Provider Name | MARTIN A DOCHERTY MD
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Gender | Male
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 10/01/2025
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Provider Practice Location Address
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Address Line | 400 VETERANS AVE
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City | BILOXI
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State | MS
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Zip | 39531-2410
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Country | US
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Telephone | 228-523-8336
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Fax |
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Provider Business Mailing Address
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Address Line | 660 S EUCLID AVE CB 8072
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City | SAINT LOUIS
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State | MO
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Zip | 63110-1010
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Country | US
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Telephone | 314-747-3000
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Fax | 314-747-4876
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | R8N60
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License Number State | MO
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