Provider Demographics
NPI:1760464754
Name:DOOLEY, THOMAS W (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:W
Last Name:DOOLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 KENHORST BLVD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19607-1532
Mailing Address - Country:US
Mailing Address - Phone:610-796-1000
Mailing Address - Fax:610-796-8018
Practice Address - Street 1:40 KENHORST BLVD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19607-1532
Practice Address - Country:US
Practice Address - Phone:610-796-1000
Practice Address - Fax:610-796-8018
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2008-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD044013E208200000X
PAR8F79208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A12979Medicare UPIN
PA156506KNHMedicare PIN