Provider Demographics
NPI:1437544004
Name:BRIAN C. DOYLE, M.D., PLC.
Entity Type:Organization
Organization Name:BRIAN C. DOYLE, M.D., PLC.
Other - Org Name:DOYLE EYE CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:603-306-7410
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
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-31
Last Update Date:2015-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0420013102207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1025179Medicaid
VTY100226259Medicare PIN