Healthcare Provider Details

I. General information

NPI: 1588611818
Provider Name (Legal Business Name): CHARLENE A DOYLE MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/30/2006
Last Update Date: 02/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

908 W 4TH NORTH ST
MORRISTOWN TN
37814-3894
US

IV. Provider business mailing address

PO BOX 636019
CINCINNATI OH
45263-6019
US

V. Phone/Fax

Practice location:
  • Phone: 423-586-4231
  • Fax: 865-985-7077
Mailing address:
  • Phone: 865-985-7234
  • Fax: 865-985-7077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number28180
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: