Provider Demographics
NPI:1184697989
Name:DOYLE, THOMAS A (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:DOYLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9400 S CICERO AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-2536
Mailing Address - Country:US
Mailing Address - Phone:708-424-3201
Mailing Address - Fax:708-424-5001
Practice Address - Street 1:450 ALKYRE RUN STE 350
Practice Address - Street 2:
Practice Address - City:WESTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:43082-6912
Practice Address - Country:US
Practice Address - Phone:614-362-2081
Practice Address - Fax:888-732-7890
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2025-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.120635207P00000X, 202K00000X
NY306066207P00000X
FLME144867207P00000X
PAMD049696L207P00000X
WV25119207P00000X
MI4301509237208D00000X, 202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA685678Medicare ID - Type Unspecified
PAE97769Medicare UPIN