Healthcare Provider Details

I. General information

NPI: 1508925348
Provider Name (Legal Business Name): BRETT COLBY DOYLE DPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 W MAIN AVE
COMANCHE OK
73529-1445
US

IV. Provider business mailing address

24963 STATE ROAD 22
CADDO OK
74729-2218
US

V. Phone/Fax

Practice location:
  • Phone: 580-439-8846
  • Fax: 580-439-8846
Mailing address:
  • Phone: 580-367-2395
  • Fax: 580-439-8846

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number11086
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: