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General NPI Number Information
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NPI Number | 1841253036
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Entity Type | Individual
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Provider Name | HERMAN ALLEN DOBBS III MD
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Gender | Male
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Dates
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Enumeration Date | 04/09/2006
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Last Update Date | 07/09/2007
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Provider Practice Location Address
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Address Line | 4212 N 16TH ST
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City | PHOENIX
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State | AZ
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Zip | 85016-5319
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Country | US
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Telephone | 602-768-8003
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Fax |
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Provider Business Mailing Address
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Address Line | 387 N 2ND AVE UNIT 1B
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City | PHOENIX
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State | AZ
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Zip | 85003-1540
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Country | US
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Telephone | 602-616-3118
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Fax |
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 34742
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 96-44
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License Number State | NM
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