Healthcare Provider Details

I. General information

NPI: 1659477826
Provider Name (Legal Business Name): SHANNON K HOBSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 OVERLOOK TERRACE
MADISON WI
53705
US

IV. Provider business mailing address

6 COUNTRY GLEN CIR
MADISON WI
53719-6202
US

V. Phone/Fax

Practice location:
  • Phone: 608-256-1901
  • Fax: 608-280-7024
Mailing address:
  • Phone: 608-256-1901
  • Fax: 608-280-7024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number2001027003
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: