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General NPI Number Information
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NPI Number | 1922104108
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Entity Type | Individual
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Provider Name | GLEN D. DOBBS PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/15/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1 ARH LANE SUITE 103
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City | LOW MOOR
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State | VA
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Zip | 24457
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Country | US
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Telephone | 540-862-6744
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 609
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City | CLIFTON FORGE
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State | VA
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Zip | 24422-0609
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Country | US
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Telephone | 540-862-6744
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 0110001229
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License Number State | VA
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