Daugherty, Joe

Daugherty, Joe is an individual health care provider with primary practice located at 1409 Braden St , Jacksonville AR 72076-3720. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Daugherty, Joe can be contacted via phone (501) 982-0576.

Contact Information

Primary practice address
1409 Braden St Jacksonville AR 72076-3720
Phone: (501) 982-0576
Fax: (501) 982-0041
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X C-4276 Arkansas

Profile Details

NPI number 1912965187
LBN Legal business name Daugherty, Joe
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 3rd, 2006
Last updated Sep 17th, 2013 - about 13 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1912965187 NPPES
Arkansas Other 5414114 AETNA
Arkansas Other 080042776 AETNA
Arkansas Other 114330000 AETNA
Arkansas MEDICAID 105932001 AETNA
Arkansas Other P01065091 AETNA
Arkansas Other SCHUMACHER GR TSG ID AETNA

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