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1134227911

NPI Code Detail

MEDICARE: DR. JENNIFER LYNN HOBBS M.D.

MEDICARE: DR. JENNIFER LYNN HOBBS M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	01048931A	IN
2	207NS0135X	Procedural Dermatology Physician	01048931A	IN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00086478	OTHER		MEDICARE RAILROAD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7192450	OTHER		AETNA
3	000000308078	OTHER		BCBS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	01048931B	OTHER	IN	CSR LICENSE NUMBER
6	11473	OTHER		PHP

General Provider Information

NPI Number	:	1134227911
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER LYNN HOBBS M.D.

Provider Business Mailing Address
First Line	:	5750 FALLS DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-7147
Country	:	US
Telephone Number	:	260-436-8000
Fax Number	:	260-432-5587

Provider Business Practice Location Address
First Line	:	5750 FALLS DR
Second Line	:
City	:	FORT WAYNE
State	:	IN
Zip	:	46804-7147
Country	:	US
Telephone Number	:	260-436-8000
Fax Number	:	260-432-5587

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	03/07/2023

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Directions to “ DR. JENNIFER LYNN HOBBS M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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