Provider Demographics
NPI:1417015603
Name:NORMAN J DOHERTY MD, PC
Entity Type:Organization
Organization Name:NORMAN J DOHERTY MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOHERTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-234-0770
Mailing Address - Street 1:3368 HIGHWAY 280
Mailing Address - Street 2:SUITE G-11
Mailing Address - City:ALEXANDER CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35010-3393
Mailing Address - Country:US
Mailing Address - Phone:256-234-0770
Mailing Address - Fax:256-234-4953
Practice Address - Street 1:3368 HIGHWAY 280
Practice Address - Street 2:SUITE G-11
Practice Address - City:ALEXANDER CITY
Practice Address - State:AL
Practice Address - Zip Code:35010-3393
Practice Address - Country:US
Practice Address - Phone:256-234-0770
Practice Address - Fax:256-234-4953
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL18082208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty