Individual provider · Type 1 NPI
Robert Lee Dougherty, PA-C
Medical Physician Assistant · Casey, IL
NPI number
1891787529
Active
Practice location
412 NW 3rd St
Casey, IL 62420-1014
Fax (217) 932-5191
Mailing address
4114 E US 40
Casey, IL 62420-3113
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Medical Physician Assistant Primary | 363AM0700X | 085000498 (IL) |
Medical Physician Assistant: Definition to come...
About NPI 1891787529
Robert Lee Dougherty, PA-C's National Provider Identifier is 1891787529, issued on Aug 18, 2005. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Casey, IL. The record was last updated on Jul 9, 2007.