| Timothy Dougherty, | |
|
636 Del Prado Blvd S, Cape Coral, FL 33990-2668 | |
| (239) 772-6513 | |
| Not Available |
| Full Name | Timothy Dougherty |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 636 Del Prado Blvd S, Cape Coral, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164487344 | NPI | - | NPPES |
| 44660 | Other | FL | BLUE CROSS BLUE SHIELD |
| 7939666 | Other | FL | AETNA |
| 221582 | Other | FL | AMERIGROUP |
| 254620500 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | ME76221 (Florida) | Primary |
| Entity Name | Lee Memorial Health System |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1992873319 PECOS PAC ID: 8729996608 Enrollment ID: O20031118000604 |
| Entity Name | Cape Coral Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1376611962 PECOS PAC ID: 1557465325 Enrollment ID: O20070404000086 |
| Mailing Address | Practice Location Address |
|---|---|
| Timothy Dougherty, 6896 W Snowville Rd, Brecksville, OH 44141-3214 Ph: () - | Timothy Dougherty, 636 Del Prado Blvd S, Cape Coral, FL 33990-2668 Ph: (239) 772-6513 |
Tucker Greene, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 636 Del Prado Blvd S, Cape Coral, FL 33990 Phone: 239-772-6513 | |
Connor Mech Montgomery, Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 636 Del Prado Blvd S, Cape Coral, FL 33990 Phone: 239-424-3513 Fax: 239-424-4039 | |
Dr. Tyler Charles Ensley, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: Cape Coral Hospital, 636 Del Prado Blvd, Cape Coral, FL 33990 Phone: 239-424-3513 Fax: 239-424-4039 | |
Alan B Claunch, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 636 Del Prado Blvd S, Cape Coral, FL 33990 Phone: 239-772-6513 Fax: 239-574-0269 | |
Dr. Michael C Haupt, M.D. Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 708 Del Prado Blvd, Suite 9, Cape Coral, FL 33990 Phone: 239-574-2644 Fax: 239-574-1451 | |
Kurt Mueller, DO Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 636 Del Prado Blvd S, 1030, Cape Coral, FL 33990 Phone: 239-424-3513 Fax: 239-424-4039 |