Healthcare Provider Details

I. General information

NPI: 1538838354
Provider Name (Legal Business Name): GARY HOBART NRP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/07/2021
Last Update Date: 09/07/2021
Certification Date: 09/07/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 E MURRAY AVE
SAINT GEORGE SC
29477-2220
US

IV. Provider business mailing address

100 E MURRAY AVE
SAINT GEORGE SC
29477-2220
US

V. Phone/Fax

Practice location:
  • Phone: 803-319-8801
  • Fax:
Mailing address:
  • Phone: 803-319-8801
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License Number002351
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: