Provider Demographics
NPI:1205147881
Name:NOBLES, DOYLE
Entity type:Individual
Prefix:
First Name:DOYLE
Middle Name:
Last Name:NOBLES
Suffix:
Gender:M
Credentials:
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 125
Mailing Address - Street 2:
Mailing Address - City:AYNOR
Mailing Address - State:SC
Mailing Address - Zip Code:29511-0125
Mailing Address - Country:US
Mailing Address - Phone:843-358-1457
Mailing Address - Fax:843-358-1458
Practice Address - Street 1:618 8TH AVE NORTH
Practice Address - Street 2:
Practice Address - City:AYNOR
Practice Address - State:SC
Practice Address - Zip Code:29511-0125
Practice Address - Country:US
Practice Address - Phone:843-358-1457
Practice Address - Fax:843-358-1458
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-29
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1926224Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapy Assistant