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Contact Information

CONNOR P DOHERTY, PA-C, ATC
333 S MADISON ST.
MUNCIE, IN47305
 Phone: 765-286-7000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physician Assistant

363A00000X 97 Physician Assistant
 

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for CONNOR P DOHERTY · (Male)

NPI Number 1831735851
Status Active
Credentials PA-C, ATC
Entity Individual
Enumeration date 11/25/2019
Last updated 04/03/2026 - About 2 months ago
Sole proprietor 1 No
Identifiers
  • IL License # 096004117
Hospital affiliation(s) Not Available
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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