Healthcare Provider Details

I. General information

NPI: 1891980132
Provider Name (Legal Business Name): THOMAS P. DOBSON D.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/10/2007
Last Update Date: 09/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 HERITAGE OAKS LN
BLUE HILL ME
04614-5971
US

IV. Provider business mailing address

19 HERITAGE OAKS LN
BLUE HILL ME
04614-5971
US

V. Phone/Fax

Practice location:
  • Phone: 207-374-5787
  • Fax:
Mailing address:
  • Phone: 207-374-5787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License NumberCR1478
License Number StateME
# 2
Primary TaxonomyN
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License NumberCR1478
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: