Provider Demographics
NPI:1871669929
Name:DOYLE, JAMES (OD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:
Last Name:DOYLE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-4204
Mailing Address - Country:US
Mailing Address - Phone:978-682-5656
Mailing Address - Fax:978-685-7959
Practice Address - Street 1:50 HAVERHILL ST
Practice Address - Street 2:
Practice Address - City:METHUEN
Practice Address - State:MA
Practice Address - Zip Code:01844-4204
Practice Address - Country:US
Practice Address - Phone:978-682-5656
Practice Address - Fax:978-685-7959
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4027152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0313378Medicaid
MAW17351Medicare ID - Type UnspecifiedINDIVIDUAL MEDICARE NUMBE
MAU75848Medicare UPIN