Provider Demographics
NPI:1063692770
Name:DOYLE, ALLISON HAILMAN (DO)
Entity type:Individual
Prefix:DR
First Name:ALLISON
Middle Name:HAILMAN
Last Name:DOYLE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:ALLISON
Other - Middle Name:HAILMAN
Other - Last Name:DOYLE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:905 S FRONTAGE RD
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-6113
Mailing Address - Country:US
Mailing Address - Phone:601-482-4955
Mailing Address - Fax:601-482-4957
Practice Address - Street 1:905 S FRONTAGE RD
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-6113
Practice Address - Country:US
Practice Address - Phone:601-482-4955
Practice Address - Fax:601-482-4957
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-09
Last Update Date:2024-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS20687207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS009014894Medicaid
MS02286218Medicaid