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General NPI Number Information
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NPI Number | 1982713699
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Entity Type | Individual
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Provider Name | JOSEPH F DAUGHERTY III MD
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 04/05/2016
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Provider Practice Location Address
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Address Line | 806 SCOTT ST
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City | COVINGTON
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State | KY
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Zip | 41011-2420
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Country | US
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Telephone | 859-371-2600
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Fax | 859-372-5923
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Provider Business Mailing Address
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Address Line | 806 SCOTT ST
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City | COVINGTON
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State | KY
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Zip | 41011-2420
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Country | US
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Telephone | 859-371-2600
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Fax | 859-372-5923
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35039319D
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 22022
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License Number State | KY
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