Provider Demographics
NPI:1801851654
Name:DOYLE, PATRICIA S (MD)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:S
Last Name:DOYLE
Suffix:
Gender:F
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:PO BOX 1599
Mailing Address - Street 2:
Mailing Address - City:BANGOR
Mailing Address - State:ME
Mailing Address - Zip Code:04402-1599
Mailing Address - Country:US
Mailing Address - Phone:207-945-5247
Mailing Address - Fax:
Practice Address - Street 1:376 MAIN ST
Practice Address - Street 2:
Practice Address - City:JACKMAN
Practice Address - State:ME
Practice Address - Zip Code:04945-5214
Practice Address - Country:US
Practice Address - Phone:207-668-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2021-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMD12236207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME154420000Medicaid
MEMM0750Medicare PIN
ME080106937Medicare PIN
ME154420000Medicaid
MM9086Medicare PIN