Healthcare Provider Details

I. General information

NPI: 1487467437
Provider Name (Legal Business Name): PAUL DOBBS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 EAGLETREE LN SW
HUNTSVILLE AL
35801-6446
US

IV. Provider business mailing address

PO BOX 1325
ATHENS AL
35612-6325
US

V. Phone/Fax

Practice location:
  • Phone: 256-541-1136
  • Fax:
Mailing address:
  • Phone: 256-541-1136
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code224L00000X
TaxonomyPedorthist
License Number189
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: