Basic Information
| Provider Information | |||||||||
| NPI: | 1043281991 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOYLE | ||||||||
| FirstName: | TIMOTHY | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5000 COX RD | ||||||||
| Address2: | |||||||||
| City: | GLEN ALLEN | ||||||||
| State: | VA | ||||||||
| PostalCode: | 230609263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8048224355 | ||||||||
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| Practice Location | |||||||||
| Address1: | 106 S MARKET ST | ||||||||
| Address2: | |||||||||
| City: | ELYSBURG | ||||||||
| State: | PA | ||||||||
| PostalCode: | 178249761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5706722574 | ||||||||
| FaxNumber: | 5706720151 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/30/2006 | ||||||||
| LastUpdateDate: | 12/08/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/08/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD058739L | PA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207R00000X | D50859 | MD | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 895L293E | 01 | MEDICARE PROVIDER NUMBER | OTHER |