Provider Demographics
NPI:1003955204
Name:DOYLE, JONATHAN A (MD)
Entity Type:Individual
Prefix:
First Name:JONATHAN
Middle Name:A
Last Name:DOYLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3444 S BOULEVARD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-5482
Mailing Address - Country:US
Mailing Address - Phone:405-285-2260
Mailing Address - Fax:405-285-2280
Practice Address - Street 1:3444 S BOULEVARD
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73013-5482
Practice Address - Country:US
Practice Address - Phone:405-285-2260
Practice Address - Fax:405-285-2280
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2010-05-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK250022084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry