Healthcare Provider Details

I. General information

NPI: 1588622070
Provider Name (Legal Business Name): DAVID J DOYLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 02/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1515 ALLEN STREET
SPRINGFIELD MA
01118
US

IV. Provider business mailing address

1515 ALLEN STREET
SPRINGFIELD MA
01118
US

V. Phone/Fax

Practice location:
  • Phone: 413-783-9114
  • Fax: 413-782-0960
Mailing address:
  • Phone: 413-783-9114
  • Fax: 413-782-0960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number46148
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number46148
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier046148
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerCONNECTICARE
# 2
Identifier777782
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerTUFTS HEALTH PLAN
# 3
Identifier0169064
Identifier TypeMEDICAID
Identifier StateMA
Identifier Issuer
# 4
IdentifierN51788
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerBLUE CROSS & BLUE SHIELD
# 5
Identifier000000025611
Identifier TypeOTHER
Identifier StateMA
Identifier IssuerBMC HEALTHNET
# 6
Identifier110005648A
Identifier TypeMEDICAID
Identifier StateMA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: