Provider Demographics
NPI:1558753293
Name:DOYLE, LORI DODD (PA-C)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:DODD
Last Name:DOYLE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 W ST NW
Mailing Address - Street 2:APT 31
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-5850
Mailing Address - Country:US
Mailing Address - Phone:703-862-6188
Mailing Address - Fax:
Practice Address - Street 1:8650 SUDLEY RD
Practice Address - Street 2:SUITE #310
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-4419
Practice Address - Country:US
Practice Address - Phone:703-753-9860
Practice Address - Fax:703-753-9863
Is Sole Proprietor?:No
Enumeration Date:2015-03-03
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0110-004888363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical