Healthcare Provider Details

I. General information

NPI: 1790710101
Provider Name (Legal Business Name): DAVID STEVE HOBBS O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 05/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 W BROADWAY ST
ARDMORE OK
73401-2818
US

IV. Provider business mailing address

1203 W BROADWAY ST
ARDMORE OK
73401-2835
US

V. Phone/Fax

Practice location:
  • Phone: 580-226-5858
  • Fax: 580-223-1476
Mailing address:
  • Phone: 580-226-5858
  • Fax: 580-223-1476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number894
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: