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.
Healthcare Provider's Profile
Full Name | Stephen Tyler Dougherty |
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Gender | Male |
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Speciality | Audiologist |
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Location | 444 Fairfax Rd, Drexel Hill, Pennsylvania |
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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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