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General NPI Number Information
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NPI Number | 1679741318
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Entity Type | Organization
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Legal Business Name | PAMELA G DOBSON DO
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Dates
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Enumeration Date | 02/15/2008
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Last Update Date | 02/19/2008
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Provider Practice Location Address
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Address Line | 211 N BROADWAY SUITE 103
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City | GREEN BAY
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State | WI
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Zip | 54303-2757
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Country | US
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Telephone | 920-445-0660
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Fax | 920-445-0661
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Provider Business Mailing Address
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Address Line | 211 N BROADWAY SUITE 103
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City | GREEN BAY
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State | WI
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Zip | 54303-2757
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Country | US
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Telephone | 920-445-0660
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Fax | 920-445-0661
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Authorized Official
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Title or Position | SOLE PROPRIETOR
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Name | DR. PAMELA GRAY DOBSON
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Credential | D.O.
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Telephone | 920-445-0660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 27190-021
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License Number State | WI
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