Provider Demographics
NPI:1689769689
Name:DOUGHTY, JOSEPH MARLIN (DC)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:MARLIN
Last Name:DOUGHTY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1124 W DILLON RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LOUISVILLE
Mailing Address - State:CO
Mailing Address - Zip Code:80027-9411
Mailing Address - Country:US
Mailing Address - Phone:303-900-4150
Mailing Address - Fax:
Practice Address - Street 1:1124 W DILLON RD
Practice Address - Street 2:SUITE 1
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-9411
Practice Address - Country:US
Practice Address - Phone:303-900-4150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2010-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX011098111N00000X
GACHIRO006402111N00000X
CO6463111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor