Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | 24495 | AZ |
N | 207QA0505X | Family Doctor - Adult Medicine | 24495 | AZ |
N | 207QG0300X | Family Doctor - Geriatric Medicine | 24495 | AZ |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 24495 | AZ |
NPI | 1114912961 |
---|---|
Provider Name | Dr. Kevin S Doyle |
First Address | Prescott, AZ 86305-7167 |
Second Address | Prescott, AZ 86305-7167 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/09/2005 |
Last Update Date | 12/08/2020 |