person
David Alan Daugherty, PA-C
Surgical Physician Assistant in Fort Wayne, Indiana
NPI 1689648214

David Alan Daugherty is a Surgical Physician Assistant based in Fort Wayne, IN and is specialized in Surgical. David Alan Daugherty practices in Fort Wayne, IN and has the professional credentials of PA-C. The NPI Number for David Alan Daugherty is 1689648214 and holds a License No. 50-002861 (Indiana).

The current practice location address for David Alan Daugherty is 7601 W Jefferson Blvd, Fort Wayne, IN and can be reached out via phone at 260-436-8686 and via fax at 260-436-8585. You can also correspond with David Alan Daugherty through the mailing address at PO BOX 2526, FORT WAYNE, IN - 46801-2526 (mailing address contact number: 260-436-8686).

Location: 7601 W Jefferson Blvd, Fort Wayne, IN, 46801-2526
person
Provider Profile Details
NPI Number
1689648214
Provider Name
David Alan Daugherty
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
7601 W Jefferson Blvd, Fort Wayne, IN, 46801-2526
Phone Number
260-436-8686
Fax Number
260-436-8585
Provider Enumeration Date
02/13/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
000000626650 01 IN ANTHEM
1084497 01 OH NCCPA
P00877355 01 RAILROAD MEDICARE
OPR 05 IN
institution
Provider Business Practice Location Address Details
Address
7601 W Jefferson Blvd
City
State
Zip
46804-4133
Phone Number
260-436-8686
Fax Number
260-436-8585
person
Provider Business Mailing Address Details
Address
Po Box 2526
City
State
Zip
46801-2526
Phone Number
260-436-8686
Fax Number
260-436-8585
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
50-002861 (Ohio)
Definition
Definition to come...
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