DR. TIMOTHY DAUGHERTY (NPI# 1780066738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780066738 |
| Entity Type | Individual |
| Full Name | DR. TIMOTHY DAUGHERTY |
| Credential | M.D. |
| Practice Address |
747 N Rutledge St Springfield IL 62702-6700 |
| Mailing Address |
Po Box 19653 Springfield IL 62794-9653 |
| Practice Telephone | 2175456112 |
| Practice Fax Number | 2175452588 |
| Mailing Telephone | 2175456112 |
| Mailing Fax Number | 2175452588 |
| Enumeration Date | 2015-06-26 |
| Last Update Date | 2015-06-26 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
125.066594 | IL | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134168099 | Timothy Kenneth Daugherty | Psychologist | 1601 Ebenezer Rd, Rock Hill, SC 29732-1808 | 2006-06-06 |
| 1699253450 | Timothy Tyler Daugherty | Student in an Organized Health Care Education/Training Program | 1364 Clifton Rd Ne, Atlanta, GA 30322-1059 | 2018-08-03 |
| 1982112157 | Timothy Daugherty | Counselor | 90 Hospital Dr, Athens, OH 45701-2301 | 2018-01-22 |
| 1063545424 | Timothy Patrick Daugherty | Occupational Therapist | 1829 East Franklin Street, Bldg. # 600, Chapel Hill, NC 27514 | 2007-03-14 |
| 1386658466 | Timothy C. Daugherty | Dentist | 4801 Manslick Rd, Louisville, KY 40216-4097 | 2006-07-27 |
| 1821031840 | Timothy Daugherty | Internal Medicine | 4451 Paulsen St, Savannah, GA 31405 | 2006-06-14 |
| Street Address |
747 N RUTLEDGE ST |
| City | SPRINGFIELD |
| State | IL |
| Zip Code | 62702-6700 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619974532 | Neha N Amin | Obstetrics & Gynecology | 747 N Rutledge St, Baylis Building, 2nd Floor, Springfield, IL 62702-6700 | 2005-07-07 |
| 1295343648 | Katherine G Brockhouse | Nurse Practitioner | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-07-21 |
| 1376151258 | Lauren Woldanski | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-07-16 |
| 1356968358 | Jessie Laina Koljonen | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-06-25 |
| 1487274882 | Tiffany Lynn Damm | Urology | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-04-26 |
| 1811516065 | Jazzmyne T Montgomery | Urology | 747 N Rutledge St, Springfield, IL 62702-6700 | 2020-04-08 |
| 1639738644 | Alexis Ruffolo | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2019-06-12 |
| 1922667930 | Justin D Sawyer | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2019-06-12 |
| 1174016950 | Michael Romanelli | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2018-06-07 |
| 1902398357 | William James Bruce | Plastic Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2018-06-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457866519 | Mohammad Jamal Uddin Ansari | Internal Medicine | 751 N Rutledge St Ste 400, Springfield, IL 62702 | 2017-12-11 |
| 1588105811 | Mickey Graphia | Surgery | 701 N 1st St # D346, Springfield, IL 62702 | 2017-03-20 |
| 1376908913 | Abdul Hannan | Internal Medicine | 315 W Carpenter St # B, Springfield, IL 62702 | 2015-12-28 |
| 1871986414 | Rachel Hoselton | Nurse Practitioner | 400 N 9th St Fl 4, Springfield, IL 62702 | 2015-03-06 |
| 1548697774 | Alyssa Wilson | Behavioral Analyst | 232 Bruns Lane, One Sparcenter Plaza, Springfield, IL 62702 | 2013-10-02 |
| 1174965446 | Amy Wilson | Speech-Language Pathologist | 2120 West Washington Street, Springfield, IL 62702 | 2013-07-26 |
| 1275898116 | Pele Boutrous Dina | Pediatrics | 415 N 9th St # 4w16, Springfield, IL 62702 | 2012-07-06 |
| 1427327733 | Brook D Croke | Genetic Counselor, MS | 400 N. 9th Street, 3rd Floor Clinic B, Springfield, IL 62702 | 2011-12-16 |
| 1629352604 | Renae M Sanchez | Pharmacist | 3216 East Clearlake Ave, Springfield, IL 62702 | 2011-10-07 |
| 1982915302 | William Leland Zelkovich | Radiology | 701 N 1st, Springfield, IL 62702 | 2010-06-30 |
| Find all providers in zip 62702 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871781765 | Andrew J Kochevar | Surgery | 1229 E Seminole St Ste 340, Springfield, MO 65804 | 2007-10-04 |
| 1730561796 | James Winters | Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2015-06-25 |
| 1205241221 | Lauren Hutchinson | Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2014-06-28 |
| 1568881407 | Connor Barnes | Surgery | 3555 S National Ave, Springfield, MO 65807-7310 | 2014-04-08 |
| 1265743140 | Abigail Maciolek Cochran | Surgery | 2901 Greenbriar Dr, Springfield, IL 62704-6425 | 2010-06-25 |
| 1366762932 | Pioneer Valley Plastic Surgery LLC | Surgery | 100 Wason Ave, Suite 360, Springfield, MA 01107-1119 | 2010-06-07 |
| 1881913002 | Steven J Covici Md Facs PC | Surgery | 125 Liberty St, Suite 308, Springfield, MA 01103-1114 | 2010-05-27 |
| 1689896144 | Erika Henkelman | Surgery | 747 N Rutledge St, Springfield, IL 62702-6700 | 2007-05-03 |
| 1497977888 | Joel Wietfeldt | Surgery | 2901 Greenbriar Dr, Springfield, IL 62704-6425 | 2007-05-03 |
| 1851327662 | Bharat Shah | Surgery | 1229 E Seminole St, Springfield, MO 65804-2227 | 2006-06-23 |
| Find all providers in SPRINGFIELD | ||||
| City | SPRINGFIELD |
| Zip Code | 62702 |
Please comment or provide details below to improve the information on DR. TIMOTHY DAUGHERTY.
| 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.