Healthcare Provider Details

I. General information

NPI: 1538412044
Provider Name (Legal Business Name): MATTHEW DAVID DOYLE O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/22/2012
Last Update Date: 10/04/2023
Certification Date: 10/04/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 TOLL GATE RD STE 107
WARWICK RI
02886-4326
US

IV. Provider business mailing address

390 TOLL GATE RD STE 107
WARWICK RI
02886-4326
US

V. Phone/Fax

Practice location:
  • Phone: 401-732-2662
  • Fax: 401-732-2662
Mailing address:
  • Phone: 401-732-2662
  • Fax: 401-732-2669

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number00588
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number00588
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: