Provider Demographics
NPI:1366428039
Name:DOYLE, RUSSELL C (DC)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:C
Last Name:DOYLE
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1014 N HIGH ST
Mailing Address - Street 2:
Mailing Address - City:MILLVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08332-2527
Mailing Address - Country:US
Mailing Address - Phone:856-327-0320
Mailing Address - Fax:856-825-4183
Practice Address - Street 1:1014 N HIGH ST
Practice Address - Street 2:
Practice Address - City:MILLVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08332-2527
Practice Address - Country:US
Practice Address - Phone:856-327-0320
Practice Address - Fax:856-825-4183
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00379800111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ15024OtherUHP
NJ561359OtherKEYSTONE
NJ0541489OtherUS HEALTHCRE
NJ0541489OtherAETNA
NJ1141964OtherHORIZON NJ HEALTH
NJ6954502Medicaid
NJNJ03798OtherLANDMARK
NJ0382704000OtherAMERIHEALTH
NJ222259623Medicare UPIN
NJ6954502Medicaid
NJ0541489OtherUS HEALTHCRE
NJNJ03798OtherLANDMARK