Stephen Tyler Dougherty, in Drexel Hill, PA - Medicare Audiologist Provider

Stephen Tyler Dougherty, is a medicare enrolled "Audiologist" provider in Drexel Hill, Pennsylvania. His current practice location is 444 Fairfax Rd, Drexel Hill, Pennsylvania. You can reach out to his office (for appointments etc.) via phone at (215) 606-7860.

Stephen Tyler Dougherty is licensed to practice in Pennsylvania (license number AT006791) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1386261311.

Contact Information

	Stephen Tyler Dougherty,
	444 Fairfax Rd, Drexel Hill, PA 19026-1209
	(215) 606-7860
	Not Available

Healthcare Provider's Profile

Full Name	Stephen Tyler Dougherty
Gender	Male
Speciality	Audiologist
Location	444 Fairfax Rd, Drexel Hill, Pennsylvania
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1386261311
Provider Enumeration Date: 06/25/2020
Last Update Date: 01/24/2024

Medicare PECOS Information:

PECOS PAC ID: 5991128175
Enrollment ID: I20200707000220

Medical Identifiers

Medical identifiers for Stephen Tyler Dougherty such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1386261311	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
231H00000X	Audiologist	30871 (Oregon)	Secondary
231H00000X	Audiologist	AT006791 (Pennsylvania)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Stephen Tyler Dougherty is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Stephen Tyler Dougherty, 444 Fairfax Rd, Drexel Hill, PA 19026-1209 Ph: (215) 606-7860	Stephen Tyler Dougherty, 444 Fairfax Rd, Drexel Hill, PA 19026-1209 Ph: (215) 606-7860

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Stephen Tyler Dougherty, - Medicare Audiologist in Drexel Hill, PA