MEDICARE: MR. BRIAN PAUL DOORLEY PT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2251X0800X	Orthopedic Physical Therapist	LPT-004054	AZ

General Provider Information

NPI Number	:	1275605727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRIAN PAUL DOORLEY PT

Provider Business Mailing Address
First Line	:	3402 N WARREN DRIVE
Second Line	:
City	:	ANTHEM
State	:	AZ
Zip	:	85086
Country	:	US
Telephone Number	:	623-551-0047
Fax Number	:

Provider Business Practice Location Address
First Line	:	2400 W DUNLAP AVE STE 145
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-2813
Country	:	US
Telephone Number	:	602-870-1414
Fax Number	:	602-870-4141

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2006
Last Update Date	:	08/13/2024

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