MEDICARE: MATTHEW DOBBS

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	376G00000X	Nursing Home Administrator	101034	AK

General Provider Information

NPI Number	:	1336560838
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MATTHEW DOBBS

Provider Business Mailing Address
First Line	:	705 W 47TH AVE
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-7111
Country	:	US
Telephone Number	:	907-699-8581
Fax Number	:

Provider Business Practice Location Address
First Line	:	705 W 47TH AVE
Second Line	:
City	:	ANCHORAGE
State	:	AK
Zip	:	99503-7111
Country	:	US
Telephone Number	:	907-699-8581
Fax Number	:

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

Provider Enumeration Date	:	12/30/2013
Last Update Date	:	12/30/2013

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Directions to “ MATTHEW DOBBS ” Practice Location

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