Provider Demographics
NPI:1902368376
Name:DOYLE, KIMBERLY ((NMD))
Entity Type:Individual
Prefix:DR
First Name:KIMBERLY
Middle Name:
Last Name:DOYLE
Suffix:
Gender:F
Credentials:(NMD)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2505 W ESTRELLA DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2518
Mailing Address - Country:US
Mailing Address - Phone:480-200-2732
Mailing Address - Fax:
Practice Address - Street 1:1631 E GUADALUPE RD STE 106
Practice Address - Street 2:
Practice Address - City:TEMPE
Practice Address - State:AZ
Practice Address - Zip Code:85283-3935
Practice Address - Country:US
Practice Address - Phone:480-200-2732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-03
Last Update Date:2019-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ19-1789175F00000X
AZ191789208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice