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NPI Code Detail

MEDICARE: DR. CARL LEROY DOBSON M.D.

MEDICARE: DR. CARL LEROY DOBSON 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
12085R0202XDiagnostic Radiology PhysicianG9583TX

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00003380OTHERTXMEDICARE RAILROAD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2DO08J0201OTHERTXBCBS
3123838OTHERTXCHIPS
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215900857
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CARL LEROY DOBSON M.D.
Provider Business Mailing Address
First Line : 3401 W. GORE BLVD.
Second Line :
City : LAWTON
State : OK
Zip : 73505-6332
Country : US
Telephone Number : 580-355-8620
Fax Number : 580-250-5827
Provider Business Practice Location Address
First Line : 3401 W. GORE BLVD.
Second Line :
City : LAWTON
State : OK
Zip : 73505-6332
Country : US
Telephone Number : 580-355-8620
Fax Number : 580-250-5827
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2006
Last Update Date : 05/11/2010

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