Stephen Tyler Dougherty
Stephen Tyler Dougherty is a Qualified Audiologist in Drexel Hill, Pennsylvania. Qualified in 2020, 6 years ago. Accepts Medicare assignment. Licensed in Oregon and Pennsylvania.
- Years since qualifying
- 6
- Licensed in
- OR, PA
- In the registry since
- 2020
- Specialties on file
- 2
Practice location Address checks out
444 Fairfax RdDrexel Hill, PA 19026-1209
Phone: (215) 606-7860
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Audiologist (primary) | Taxonomy 231H00000X · Licence AT006791 (PA) |
|---|---|
| Audiologist | Taxonomy 231H00000X · Licence 30871 (OR) |
Record details
| NPI number | 1386261311 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 25, 2020 |
| Last updated in NPPES | January 24, 2024 |
| Certification date | January 24, 2024 |
| Mailing address | 444 Fairfax Rd, Drexel Hill, PA 19026-1209 |
Medicare enrollment
| Medicare specialty | QUALIFIED AUDIOLOGIST |
|---|---|
| Medical school | OTHER |
| Graduated | 2020 (6 years in practice) |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 2 on file with Medicare |