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General NPI Number Information
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NPI Number | 1083649909
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Entity Type | Individual
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Provider Name | GLENN LEE DOBBS D.O.
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Gender | Male
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Dates
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Enumeration Date | 07/11/2006
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Last Update Date | 09/14/2012
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Provider Practice Location Address
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Address Line | 1205 HADLEY RD
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City | MOORESVILLE
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State | IN
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Zip | 46158-1789
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Country | US
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Telephone | 317-584-3454
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Fax | 317-584-3435
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Provider Business Mailing Address
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Address Line | 8051 S. EMERSON AVENUE #400
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-8633
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Country | US
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Telephone | 317-865-3600
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Fax | 317-865-3850
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 02001767A
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License Number State | IN
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