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General NPI Number Information
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NPI Number | 1053369660
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Entity Type | Individual
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Provider Name | KATHLEEN DOYLE MD
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Gender | Female
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Dates
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Enumeration Date | 05/05/2006
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Last Update Date | 05/02/2008
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Provider Practice Location Address
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Address Line | 2825 HUNTERS TRL 1ST FLOOR
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City | PORTAGE
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State | WI
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Zip | 53901-3429
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Country | US
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Telephone | 608-742-7161
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Fax | 608-745-3060
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Provider Business Mailing Address
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Address Line | 2825 HUNTERS TRL
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City | PORTAGE
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State | WI
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Zip | 53901-3429
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Country | US
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Telephone | 608-742-7161
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Fax | 608-745-3060
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 20386-020
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License Number State | WI
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