Healthcare Provider Details

I. General information

NPI: 1477526481
Provider Name (Legal Business Name): DAVID O DOBIE CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 05/09/2023
Certification Date: 05/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42570 S AIRPORT RD CYPRESS POINTE SURGICAL HOSPITAL
HAMMOND LA
70403-0946
US

IV. Provider business mailing address

201 ANNABERG DR
YOUNGSVILLE LA
70592-5740
US

V. Phone/Fax

Practice location:
  • Phone: 985-510-6135
  • Fax: 985-510-6202
Mailing address:
  • Phone: 504-442-4393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberRN094021
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAP06330
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number10415
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: