Dougherty, Christopher P

Dougherty, Christopher P is an individual health care provider with primary practice located at 1504 Se 28Th St , Bentonville AR 72712-3988. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Dougherty, Christopher P can be contacted via phone (479) 273-1111.

Contact Information

Primary practice address
1504 Se 28Th St Bentonville AR 72712-3988
Phone: (479) 273-1111
Fax: (479) 273-1255
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X E476114 Arkansas
Allopathic & Osteopathic Physicians / Sports Medicine 207XX0005X 2003014160 Missouri

Profile Details

NPI number 1124012000
LBN Legal business name Dougherty, Christopher P
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated Oct 8th, 2009 - about 17 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 1124012000 NPPES
Arkansas MEDICAID 161277002
Arkansas MEDICAID 206074312

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