Provider Demographics
NPI:1174891097
Name:TWEET, DOYLE ALAN
Entity type:Individual
Prefix:MR
First Name:DOYLE
Middle Name:ALAN
Last Name:TWEET
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6302 BARKER RD
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66218-9332
Mailing Address - Country:US
Mailing Address - Phone:913-708-4810
Mailing Address - Fax:
Practice Address - Street 1:11021 SHAWNEE MISSION PKWY
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:KS
Practice Address - Zip Code:66203-3515
Practice Address - Country:US
Practice Address - Phone:913-268-4980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-06
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11848183500000X
MO2011006694183500000X
IA21398183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist