Thomas Patrick Dougherty
Oral and Maxillofacial Surgeon
5317 Limestone Rd
Wilmington
, Delaware 19808-1252
Thomas Patrick Dougherty
Oral and Maxillofacial Surgeon
5317 Limestone Rd
Wilmington
, Delaware 19808-1252
(302) 239-2500
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Thomas Patrick Dougherty
- 5317 Limestone Rd
- Wilmington, DE
- Zip : 19808-1035
- Phone : (302) 239-2500
Second Address
- Thomas Patrick Dougherty
- 5317 Limestone Rd
- Wilmington, DE
- Zip : 19808-1252
- Fax : (302) 239-0550
- Phone : (302) 239-2500
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | G10000905 | DE |
National Provider Identifier
| NPI | 1043374515 |
|---|---|
| Provider Name | Thomas Patrick Dougherty |
| First Address | Wilmington, DE 19808-1035 |
| Second Address | Wilmington, DE 19808-1252 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 20/12/2006 |
| Last Update Date | 13/08/2008 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 0000912501 | (05) | DE |
| 54490 | AETNA (01) | CT |
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.