Provider Demographics
NPI:1083905590
Name:DOYLE, BRIAN CHRISTOPHER (MD)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:CHRISTOPHER
Last Name:DOYLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 RIVER ST STE 204
Mailing Address - Street 2:
Mailing Address - City:MONTPELIER
Mailing Address - State:VT
Mailing Address - Zip Code:05602-3750
Mailing Address - Country:US
Mailing Address - Phone:802-229-9554
Mailing Address - Fax:802-229-5906
Practice Address - Street 1:81 RIVER ST STE 204
Practice Address - Street 2:
Practice Address - City:MONTPELIER
Practice Address - State:VT
Practice Address - Zip Code:05602-3750
Practice Address - Country:US
Practice Address - Phone:802-229-9554
Practice Address - Fax:802-229-5906
Is Sole Proprietor?:No
Enumeration Date:2011-05-02
Last Update Date:2022-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT042.0013102207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1025180Medicaid
VT1025180Medicaid