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Contact Information

CHRISTOPHER P DOUGHERTY, DO
1504 SE 28TH ST
BENTONVILLE, AR72712-3988
 Phone: 479-273-1111
 Fax: 479-273-1255
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Sports Medicine

207XX0005X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for CHRISTOPHER P DOUGHERTY · (Male)

NPI Number 1124012000
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 09/07/2005
Last updated 10/08/2009 - About 17 years ago
Sole proprietor 1 No
Identifiers
  • AR License # E476114
  • MO License # 2003014160
  • AR Medicaid 161277002
  • MO Medicaid 206074312
Hospital affiliation(s)
  • MERCY MEDICAL CENTER - (Acute Care)
    2710 RIFE MEDICAL LANE
    ROGERS, AR 72758
  • NW ARKANSAS HOSPITALS LLC - (Acute Care)
    609 WEST MAPLE AVENUE
    SPRINGDALE, AR 72764
  • OZARKS COMMUNITY HOSPITAL OF GRAVETTE - (Critical Access)
    1101 JACKSON STREET SW
    GRAVETTE, AR 72736
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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