Healthcare Provider Details

I. General information

NPI: 1992320105
Provider Name (Legal Business Name): NOAH THOMAS DOBSON PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2020
Last Update Date: 05/01/2026
Certification Date: 05/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3742 W 2150 N STE 150
LEHI UT
84048-7802
US

IV. Provider business mailing address

286 W 710 N
CENTERVILLE UT
84014-1804
US

V. Phone/Fax

Practice location:
  • Phone: 385-220-6257
  • Fax:
Mailing address:
  • Phone: 775-335-9221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number12444027-1206
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: