Provider Demographics
NPI:1700017902
Name:DOYLE, TIMOTHY FRANCIS-MOONEY (DO)
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:FRANCIS-MOONEY
Last Name:DOYLE
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 1:833 S GOVERNORS AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:DE
Mailing Address - Zip Code:19904-4158
Mailing Address - Country:US
Mailing Address - Phone:302-674-1121
Mailing Address - Fax:302-674-3891
Practice Address - Street 1:833 S GOVERNORS AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:DE
Practice Address - Zip Code:19904-4158
Practice Address - Country:US
Practice Address - Phone:302-674-1121
Practice Address - Fax:302-674-3891
Is Sole Proprietor?:No
Enumeration Date:2009-08-05
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014823207W00000X
NJ25MB08585000207W00000X
DEC2-0009503207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1700017902Medicaid