Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 3015251 | KY |
NPI | 1033718465 |
---|---|
Provider Name | Mallory Ann Doyle |
First Address | Louisville, KY 40272-2673 |
Second Address | Elizabethtown, KY 42701-8437 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/10/2020 |
Last Update Date | 20/10/2020 |