Provider Demographics
NPI:1740248665
Name:DOYLE, SUSAN K (MD)
Entity type:Individual
Prefix:
First Name:SUSAN
Middle Name:K
Last Name:DOYLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:SUSAN
Other - Middle Name:K
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:3600 STELZER ROAD
Mailing Address - Street 2:SUITE 220
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43219
Mailing Address - Country:US
Mailing Address - Phone:614-475-0811
Mailing Address - Fax:614-475-0857
Practice Address - Street 1:3600 STELZER ROAD
Practice Address - Street 2:SUITE 220
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43219
Practice Address - Country:US
Practice Address - Phone:614-475-0811
Practice Address - Fax:614-475-0857
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35052714207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH160043335OtherRAILROAD MEDICARE
OH0711715Medicaid
A17330Medicare UPIN
OH160043335OtherRAILROAD MEDICARE