| Doctor Name: | MR. GERARD FRANCIS DOUGHERTY |
| NPI Number: | 1073628673 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.A. |
| License Number: | PA00402 |
| Business Practice Address: | 115 Cass Ave Woonsocket, RI - 028954705 |
| Business Phone Number: | 4017694100 |
| Business Fax Number: | |
| Mailing Address: | Po Box 7321, LACONIA |
| State: | NH |
| Postal Code: | 032477321 |
| Phone Number: | 6032930969 |
| Fax Number: | |
| NPI Enumeration Date: | 08/21/2006 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA00402 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | RI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |