Healthcare Provider Details

I. General information

NPI: 1912501198
Provider Name (Legal Business Name): LES ADRIAN DOBYNS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2020
Last Update Date: 10/07/2026
Certification Date: 10/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2690 PRESTWICK VILLAGE CIR
SPRINGFIELD OH
45503-7121
US

IV. Provider business mailing address

1829 ELAINA DR
SPRINGFIELD OH
45503-6407
US

V. Phone/Fax

Practice location:
  • Phone: 937-629-0669
  • Fax:
Mailing address:
  • Phone: 937-360-3276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: