Provider Demographics
NPI:1619197241
Name:DOYLE, LUCAS WAYNE (AUD)
Entity Type:Individual
Prefix:MR
First Name:LUCAS
Middle Name:WAYNE
Last Name:DOYLE
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 W NORTH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45504-2956
Mailing Address - Country:US
Mailing Address - Phone:937-323-6129
Mailing Address - Fax:937-525-0977
Practice Address - Street 1:1905 W NORTH ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-2956
Practice Address - Country:US
Practice Address - Phone:937-323-6129
Practice Address - Fax:937-525-0977
Is Sole Proprietor?:No
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHA-01460231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist