Healthcare Provider Details

I. General information

NPI: 1225277239
Provider Name (Legal Business Name): LANCE DOYLE DC PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2009
Last Update Date: 03/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1050 W VANDAMENT AVE
YUKON OK
73099-3877
US

IV. Provider business mailing address

1050 W VANDAMENT AVE
YUKON OK
73099-3877
US

V. Phone/Fax

Practice location:
  • Phone: 405-354-5753
  • Fax: 405-354-5828
Mailing address:
  • Phone: 405-354-5753
  • Fax: 405-354-5828

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number3911
License Number StateOK

VIII. Authorized Official

Name: DR. LANCE B DOYLE
Title or Position: CHIROPRACTOR/OWNER
Credential: D.C.
Phone: 405-354-5753