Healthcare Provider Details

I. General information

NPI: 1336350172
Provider Name (Legal Business Name): DWIGHT A DOBBINS R.PH.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 04/29/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 W HARDING RD
SPRINGFIELD OH
45504-1707
US

IV. Provider business mailing address

400 W HARDING RD
SPRINGFIELD OH
45504-1707
US

V. Phone/Fax

Practice location:
  • Phone: 937-399-8531
  • Fax: 937-399-4911
Mailing address:
  • Phone: 937-399-8531
  • Fax: 937-399-4911

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number03318519
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: