Dr. Christopher P Dougherty
Sports Medicine Orthopaedic Surgeon
1504 Se 28th St
Bentonville
, Arkansas 72712-3988
Dr. Christopher P Dougherty
Sports Medicine Orthopaedic Surgeon
1504 Se 28th St
Bentonville
, Arkansas 72712-3988
(479) 273-1255
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About
Features
Specialties
- Sports Medicine Orthopaedic Surgeon
Languages spoken
- English
Location
First Address
- Dr. Christopher P Dougherty
- 1504 Se 28th St
- Bentonville, AR
- Zip : 72712-3988
- Fax : (479) 273-1255
- Phone : (479) 273-1111
Second Address
- Dr. Christopher P Dougherty
- 1504 Se 28th St
- Bentonville, AR
- Zip : 72712-3988
- Fax : (479) 273-1255
- Phone : (479) 273-1111
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 2003014160 | MO |
| Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | E476114 | AR |
National Provider Identifier
| NPI | 1124012000 |
|---|---|
| Provider Name | Dr. Christopher P Dougherty |
| First Address | Bentonville, AR 72712-3988 |
| Second Address | Bentonville, AR 72712-3988 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 07/09/2005 |
| Last Update Date | 08/10/2009 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 161277002 | (05) | AR |
| 206074312 | (05) | MO |
| G68461 | (02) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.