MEDICARE: DR. ANDREA DOBBINS OD

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	152W00000X	Optometrist	18004489A	IN

General Provider Information

NPI Number	:	1578303681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ANDREA DOBBINS OD

Provider Business Mailing Address
First Line	:	2017 WINSLET WAY APT 2B
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46217-9498
Country	:	US
Telephone Number	:	317-373-2858
Fax Number	:

Provider Business Practice Location Address
First Line	:	1164 17TH ST
Second Line	:
City	:	KOKOMO
State	:	IN
Zip	:	46902-1901
Country	:	US
Telephone Number	:	765-457-5384
Fax Number	:	855-326-4293

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

Provider Enumeration Date	:	05/28/2024
Last Update Date	:	06/25/2024

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