Provider Demographics
NPI:1952340960
Name:DOYLE, PATRICK B (MD)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:B
Last Name:DOYLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PATRICK
Other - Middle Name:BRIAN
Other - Last Name:DOYLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3105 ELBERN AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2032
Mailing Address - Country:US
Mailing Address - Phone:614-231-5644
Mailing Address - Fax:
Practice Address - Street 1:3105 ELBERN AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43209-2032
Practice Address - Country:US
Practice Address - Phone:614-231-5644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.049579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0583462Medicaid
OH000000019015OtherANTHEM BC/BS
OH0100384OtherUNITED HEALTHCARE OF OHIO
OHDO0544335Medicare ID - Type Unspecified
OH0583462Medicaid