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:
Health care specialties
Specialty | Code | License # | 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 11 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
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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