Healthcare Provider Details

I. General information

NPI: 1508659723
Provider Name (Legal Business Name): BRIAN L HOBARD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/28/2025
Last Update Date: 05/28/2025
Certification Date: 05/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 PRINCESS ST
CAMPBELL OH
44405
US

IV. Provider business mailing address

124 PRINCESS ST
CAMPBELL OH
44405-1921
US

V. Phone/Fax

Practice location:
  • Phone: 330-518-2960
  • Fax:
Mailing address:
  • Phone: 330-518-2960
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374U00000X
TaxonomyHome Health Aide
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: