Healthcare Provider Details

I. General information

NPI: 1467465328
Provider Name (Legal Business Name): HOBBS OPTOMETRY, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 02/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

594 RIVER HIGHWAY
MOORESVILLE NC
28117-6829
US

IV. Provider business mailing address

2435 PLANTATION CENTER DRIVE SUITE 120
MATTHEWS NC
28105-5147
US

V. Phone/Fax

Practice location:
  • Phone: 704-662-3909
  • Fax: 704-662-3909
Mailing address:
  • Phone: 704-662-3909
  • Fax: 704-662-3909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number1905
License Number StateNC

VIII. Authorized Official

Name: BENJAMIN L HOBBS
Title or Position: PRESIDENT
Credential: OD
Phone: 704-708-5659