Provider Demographics
NPI:1497896518
Name:DOYLE, JOHN MARK (RPH)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:MARK
Last Name:DOYLE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 KAYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:BOALSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:16827-1685
Mailing Address - Country:US
Mailing Address - Phone:814-466-7663
Mailing Address - Fax:814-364-2353
Practice Address - Street 1:2827 EARLYSTOWN ROAD
Practice Address - Street 2:
Practice Address - City:CENTRE HALL
Practice Address - State:PA
Practice Address - Zip Code:16828
Practice Address - Country:US
Practice Address - Phone:814-364-1608
Practice Address - Fax:814-364-2353
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP 027728L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist