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General NPI Number Information
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NPI Number | 1548551302
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Entity Type | Organization
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Legal Business Name | BEDFORD REGIONAL FOOT & ANKLE CARE, LLC
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 04/28/2011
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Provider Practice Location Address
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Address Line | 602 E PITT ST
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City | BEDFORD
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State | PA
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Zip | 15522-9723
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Country | US
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Telephone | 814-623-9418
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Fax | 814-623-0561
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Provider Business Mailing Address
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Address Line | 602 E PITT ST
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City | BEDFORD
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State | PA
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Zip | 15522-9723
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Country | US
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Telephone | 814-623-9418
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Fax | 814-623-0561
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Authorized Official
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Title or Position | OWNER
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Name | DR. PATRICK RYAN DOYLE
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Credential |
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Telephone | 215-828-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | SC005922
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License Number State | PA
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