Provider Demographics
NPI:1710636238
Name:DOHERTY, COLLIN (DO)
Entity type:Individual
Prefix:
First Name:COLLIN
Middle Name:
Last Name:DOHERTY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 WOODMONT BLVD STE 600
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37205-5250
Mailing Address - Country:US
Mailing Address - Phone:615-706-8357
Mailing Address - Fax:
Practice Address - Street 1:725 W APACHE TRL STE 4
Practice Address - Street 2:
Practice Address - City:APACHE JUNCTION
Practice Address - State:AZ
Practice Address - Zip Code:85120-3963
Practice Address - Country:US
Practice Address - Phone:480-870-7130
Practice Address - Fax:480-906-2171
Is Sole Proprietor?:No
Enumeration Date:2022-03-22
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program