Healthcare Provider Details

I. General information

NPI: 1326452582
Provider Name (Legal Business Name): JAMES HOBBY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/16/2014
Last Update Date: 07/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7210 W MAIN ST
BELLEVILLE IL
62223
US

IV. Provider business mailing address

7210 W MAIN ST
BELLEVILLE IL
62223-3038
US

V. Phone/Fax

Practice location:
  • Phone: 618-398-8840
  • Fax:
Mailing address:
  • Phone: 618-398-8840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number036145508
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: