Individual provider · Type 1 NPI

David Alan Daugherty, PA-C

Surgical Physician Assistant · Fort Wayne, IN

NPI number 1689648214 Active

Practice location

7601 W Jefferson Blvd
Fort Wayne, IN 46804-4133

Call (260) 436-8686 Map

Fax (260) 436-8585

Mailing address

PO Box 2526
Fort Wayne, IN 46801-2526

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant 363AS0400X50-002861 (OH)
Surgical Physician Assistant Primary 363AS0400X10001118A (IN)

Surgical Physician Assistant: Definition to come...

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About NPI 1689648214

David Alan Daugherty, PA-C's National Provider Identifier is 1689648214, issued on Feb 13, 2006. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Fort Wayne, IN. The record was last updated on Nov 7, 2016.