Individual
DOYLE ROBERT WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0006
(706) 721-1633
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
12974
GA
Other
Enumeration date
06/12/2021
Last updated
06/12/2021
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