Provider Demographics
NPI:1811169329
Name:DOYLE, PATRICK RYAN (DPM)
Entity type:Individual
Prefix:DR
First Name:PATRICK
Middle Name:RYAN
Last Name:DOYLE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:602 E PITT ST
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15522-9723
Mailing Address - Country:US
Mailing Address - Phone:814-623-9418
Mailing Address - Fax:814-623-0561
Practice Address - Street 1:602 E PITT ST
Practice Address - Street 2:
Practice Address - City:BEDFORD
Practice Address - State:PA
Practice Address - Zip Code:15522-9723
Practice Address - Country:US
Practice Address - Phone:814-623-9418
Practice Address - Fax:814-623-0561
Is Sole Proprietor?:No
Enumeration Date:2008-03-25
Last Update Date:2011-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005922213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00767801OtherMEDICARE RAILROAD PART B PTAN
PA157760H59OtherMEDICARE PTAN