Provider Demographics
NPI:1043496565
Name:DOYLE, JESSICA MING-CHU (MD)
Entity Type:Individual
Prefix:MS
First Name:JESSICA
Middle Name:MING-CHU
Last Name:DOYLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2213 EXCHANGE PL SE
Mailing Address - Street 2:
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30013-6723
Mailing Address - Country:US
Mailing Address - Phone:770-483-4431
Mailing Address - Fax:770-760-7200
Practice Address - Street 1:2213 EXCHANGE PL SE
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30013-6723
Practice Address - Country:US
Practice Address - Phone:770-483-4431
Practice Address - Fax:770-760-7200
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA002850208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics