Healthcare Provider Details

I. General information

NPI: 1255593521
Provider Name (Legal Business Name): CHARLES EDWIN HOBSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 06/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 SW ARCHER RD
GAINESVILLE FL
32610-3003
US

IV. Provider business mailing address

3956 SW 3RD AVE
GAINESVILLE FL
32607-2784
US

V. Phone/Fax

Practice location:
  • Phone: 352-273-7592
  • Fax:
Mailing address:
  • Phone: 352-514-2854
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberTRN13114
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: