Daugherty, David Alan

Daugherty, David Alan is an individual health care provider with primary practice located at 7601 W Jefferson Blvd , Fort Wayne IN 46804-4133. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Surgical, which is considered as his primary health care specialty. Daugherty, David Alan can be contacted via phone (260) 436-8686.

Contact Information

Primary practice address
7601 W Jefferson Blvd Fort Wayne IN 46804-4133
Phone: (260) 436-8686
Fax: (260) 436-8585
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 50-002861 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 10001118A Indiana

Profile Details

NPI number 1689648214
LBN Legal business name Daugherty, David Alan
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Nov 7th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1689648214 NPPES
Indiana Other 000000626650 ANTHEM
Indiana Other 1084497 ANTHEM
Indiana Other P00877355 ANTHEM
Indiana MEDICAID OPR ANTHEM

Popular Providers