RYAN DOUGHERTY NPI 1508506155

NPI Information

Ryan Dougherty is a student health clinic center in Jonesboro, AR. Ryan Dougherty NPI is 1508506155. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2405 AGGIE ROAD
WILSON HALL
JONESBORO, AR
ZIP 72401
Phone: (870) 972-2786

The NPI 1508506155 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/31/2022 and was last updated on 3/31/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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