Provider Demographics
NPI:1245204395
Name:ASHBURN, DOYLE D (DO)
Entity type:Individual
Prefix:DR
First Name:DOYLE
Middle Name:D
Last Name:ASHBURN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL DR STE 306
Mailing Address - Street 2:
Mailing Address - City:LEWISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17837-9350
Mailing Address - Country:US
Mailing Address - Phone:570-522-4110
Mailing Address - Fax:570-768-3911
Practice Address - Street 1:1 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:LEWISBURG
Practice Address - State:PA
Practice Address - Zip Code:17837-9350
Practice Address - Country:US
Practice Address - Phone:570-522-4264
Practice Address - Fax:570-768-3709
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2022-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS010352L207R00000X, 208M00000X, 207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23457-604GOtherGEISINGER
PACA5965OtherRAILROAD MEDICARE
PA708774OtherKEYSTONE
PA001854903Medicaid
PA1312516OtherHIGHMARK BLUE SHIELD
PA325055OtherHEALTH AMERICA
PA118438711OtherDEPARTMENT OF LABOR
PA1036890OtherGATEWAY
PA232809429OtherTRICARE
PA50003320OtherCAPITAL BLUE CROSS
PA052284Medicare ID - Type Unspecified
PACA5965OtherRAILROAD MEDICARE