Marilyn Dougherty MD., PC.

Primary specialty

Ophthalmology PhysicianTaxonomy code 207W00000X

License

23203 Issued in CO

Legal business name

MARILYN DOUGHERTY MD., PC.

Practice address

385 Broadway St
Boulder, CO 80305-3344

Phone

(303) 449-3770

Fax

(303) 449-5383

NPI assigned

Aug 10, 2011

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Marilyn Dougherty, M.D.

Title

Owner

Phone

(303) 449-3770

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1312934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1316390400000",
    "number": "1598044463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803053344",
            "telephone_number": "303-449-3770",
            "fax_number": "303-449-5383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "385 BROADWAY ST",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803053344",
            "telephone_number": "303-449-3770",
            "fax_number": "303-449-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARILYN DOUGHERTY MD., PC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-10",
        "last_updated": "2011-09-19",
        "status": "A",
        "authorized_official_last_name": "DOUGHERTY",
        "authorized_official_first_name": "MARILYN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "303-449-3770",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Ophthalmology",
            "state": "CO",
            "license": "23203",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01232032",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maren Benevento LCSW LLC
• Rebecca Maret, L.AC.
• Marian Salley LCSW LLC
• Regina Anne Marian, R.N., M.A.
• Alicia Rose Marie, RN
• Ashley Marin, LPC
• Don P Marinelli, PH.D
• Amanda Leigh Markert, LCPC, LAC
• Natalie Victoria Markland, DPT, ATC
• Markle Solutions, LLC

• Ophthalmology Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Ophthalmology Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.