Basic Information
Provider Information
NPI: 1699755041
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: DOYLE
FirstName: PATRICIA
MiddleName: KENNEY
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1701 WESTCHESTER DRIVE
Address2: SUITE 850
City: HIGH POINT
State: NC
PostalCode: 272627254
CountryCode: US
TelephoneNumber: 3368022400
FaxNumber: 3368022534
Practice Location
Address1: 810 N LINDSAY ST
Address2:  
City: HIGH POINT
State: NC
PostalCode: 272623902
CountryCode: US
TelephoneNumber: 3368022060
FaxNumber: 3368022061
Other Information
ProviderEnumerationDate: 01/20/2006
LastUpdateDate: 02/28/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363A00000X02386NCY Physician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant 

No ID Information.


Home