Healthcare Provider Details

I. General information

NPI: 1821026931
Provider Name (Legal Business Name): BEN L HOBBS OD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8180 SOUTH TRYON ST
CHARLOTTE NC
28273
US

IV. Provider business mailing address

8180 SOUTH TRYON ST
CHARLOTTE NC
28273
US

V. Phone/Fax

Practice location:
  • Phone: 704-588-9219
  • Fax: 704-588-9219
Mailing address:
  • Phone: 704-588-9219
  • Fax: 704-588-9219

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1953
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: