Individual
MR. RUSSELL WAYNE DOYLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
2540 SISTER MARY COLUMBA DR, RED BLUFF, CA 96080-4327
(530) 528-8899
(530) 528-8898
Mailing address
2540 SISTER MARY COLUMBA DR, RED BLUFF, CA 96080-4327
(530) 528-8899
(530) 528-8898
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA11684
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ27575Z
GROUP ID NUMBER
CA
Enumeration date
08/04/2006
Last updated
11/20/2007
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