Provider Demographics
NPI:1245691963
Name:COLIN DOYLE MD LLC
Entity type:Organization
Organization Name:COLIN DOYLE MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:COLIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:DOYLE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:208-503-0629
Mailing Address - Street 1:3779 SWALLOWS NEST CT
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-1738
Mailing Address - Country:US
Mailing Address - Phone:208-503-0629
Mailing Address - Fax:
Practice Address - Street 1:3779 SWALLOWS NEST CT
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-1738
Practice Address - Country:US
Practice Address - Phone:208-503-0629
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00014948207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty