Provider Demographics
NPI:1669628400
Name:MJ DOYLE INC
Entity Type:Organization
Organization Name:MJ DOYLE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:J
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:219-838-9000
Mailing Address - Street 1:9521 INDIANAPOLIS BLVD STE L
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:IN
Mailing Address - Zip Code:46322-2641
Mailing Address - Country:US
Mailing Address - Phone:219-838-9000
Mailing Address - Fax:219-838-3316
Practice Address - Street 1:9521 INDIANAPOLIS BLVD STE L
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:IN
Practice Address - Zip Code:46322-2641
Practice Address - Country:US
Practice Address - Phone:219-838-9000
Practice Address - Fax:219-838-3316
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2023-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08000890A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN100215000Medicaid
IN350051527OtherRAILROAD MEDICARE
IN178950Medicare PIN
INT34991Medicare UPIN