DR. PHILIP JOHN DOUGHERTY (NPI# 1750647913) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750647913 |
| Entity Type | Individual |
| Full Name | DR. PHILIP JOHN DOUGHERTY |
| Credential | M.D. |
| Practice Address |
700 W Ironwood Dr Ste 175 Coeur D Alene ID 83814-4401 |
| Practice Telephone | 0862563092 |
| Mailing Telephone | 0862563092 |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2018-12-14 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
M-14068 | ID | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 101 W 8th Ave, Spokane, WA 992042307 | 2069207057 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811961030 | Philip Rettew Dougherty | Dentist | 7615 Sw Capitol Hwy, Portland, OR 97219-2436 | 2006-02-14 |
| Street Address |
700 W IRONWOOD DR STE 175 |
| City | COEUR D ALENE |
| State | ID |
| Zip Code | 83814-4401 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356992309 | Kendall Ann Gunderson | Nurse Practitioner | 700 W Ironwood Dr Ste 175, Coeur D Alene, ID 83814-4401 | 2019-09-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477162675 | Dehra Mcfaddan | Social Worker | 211 E. Coeur D'alene Ave, 102, Coeur D Alene, ID 83814 | 2020-07-24 |
| 1043838634 | Yendi Labelle | Nurse Practitioner | 1115 N Ironwood Drive, Coeur D'alene, ID 83814 | 2020-07-09 |
| 1295353217 | Cultivation, LLC | Counselor | 211 E. Coeur Dalene Ave. Ste 102, Coeur D'alene, ID 83814 | 2020-07-07 |
| 1306487517 | Northwest Integrated Health, LLP | Clinic/Center | 1250 West N. Northwood Center Ct, Suite B, Coeur D'alene, ID 83814 | 2019-09-30 |
| 1730740465 | Connor Williams | Physical Therapist | 1812 W Lakewood Dr, Ste. 100, Coeur D Alene, ID 83814 | 2019-06-24 |
| 1912480153 | Nadine M Lewis | Social Worker | 211 E. Coeur D'alene Ave., Coeur D'alene, ID 83814 | 2018-09-13 |
| 1992208631 | Orthopedic Surgery and Sports | Orthopaedic Surgery | 1812 N Lakewood Drive, Suite 100, Coeur D'alene, ID 83814 | 2018-03-08 |
| 1346758042 | Heather Marie Johnson | Counselor | 7905 Meadowlark Way, Cda, ID 83814 | 2018-01-16 |
| 1881113413 | Brevity Treatment Services | Counselor | 2201 N. Government Way Ste. L, Coeur D'alene, ID 83814 | 2017-09-14 |
| 1366969628 | Jennifer La Gina Highfield | Massage Therapist | 1104 N Ste B, Coeur D Alene, ID 83814 | 2017-08-28 |
| Find all providers in zip 83814 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578903191 | Miriam Bryna Hulkower | Radiology | 1839 N Govt Way Ste B, Coeur D Alene, ID 83814-3454 | 2013-06-27 |
| 1013080787 | Michael Gerardo Melendez | Radiology | 2789 E Spyglass Ct, Coeur D Alene, ID 83815 | 2006-11-17 |
| 1316971419 | Teresa Huchun | Radiology | 1620 Northwest Blvd, Suite 301, Coeur D Alene, ID 83814-2488 | 2006-07-11 |
| 1992752067 | Monte Fredrick Zarlingo | Radiology | 4000 E Sky Harbor Dr, Coeur D Alene, ID 83814-7537 | 2006-05-27 |
| 1366490773 | John Roger Anderson | Radiology | 8611 W Eagle Ridge Rd, Coeur D Alene, ID 83814-9565 | 2006-05-05 |
| 1669462107 | Ara Kassarjian | Radiology | 250 Northwest Blvd, Suite #202, Coeur D Alene, ID 83814-2974 | 2005-10-26 |
| 1154311694 | Suzanne Lei Aquino | Radiology | 1839 N Government Way Ste B, Coeur D Alene, ID 83814-3454 | 2005-10-26 |
| 1578553483 | Conrad Wittram | Radiology | 601 E Front Ave, Suite 502, Coeur D Alene, ID 83814-2701 | 2005-10-24 |
| 1043209893 | George F. Knight | Radiology | 601 Front Avenue, Suite #502, Coeur D Alene, ID 83814 | 2005-10-14 |
| 1912909623 | Lee J Secrist | Radiology | 3754 S Brentwood Ln, Coeur D Alene, ID 83814-7053 | 2005-08-12 |
| Find all providers in COEUR D ALENE | ||||
| City | COEUR D ALENE |
| Zip Code | 83814 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.