Provider Demographics
NPI:1649473778
Name:DOUGHTY, STEPHEN J (ND)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:DOUGHTY
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:493 E KAYS CIR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:UT
Mailing Address - Zip Code:84780-2162
Mailing Address - Country:US
Mailing Address - Phone:435-669-9577
Mailing Address - Fax:888-880-8230
Practice Address - Street 1:493 E KAYS CIR
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:UT
Practice Address - Zip Code:84780-2162
Practice Address - Country:US
Practice Address - Phone:435-669-9577
Practice Address - Fax:888-880-8230
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-06
Last Update Date:2024-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6499917-8919175F00000X
AZ07-987175F00000X
UT6499917-7100175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT6499917-8919OtherUTAH DOPL
UT6499917-7101OtherNATUROPATHIC PHYSICIAN
UT6499917-8919OtherUTAH DOPL