MEDICARE: KATHY LEIGH DOBER

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	171W00000X	Contractor	1979019	AZ

General Provider Information

NPI Number	:	1841525854
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHY LEIGH DOBER

Provider Business Mailing Address
First Line	:	994 S HARRISON RD
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85748-6608
Country	:	US
Telephone Number	:	520-721-1887
Fax Number	:

Provider Business Practice Location Address
First Line	:	6927 E NELSON DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85730-1665
Country	:	US
Telephone Number	:	520-342-6764
Fax Number	:

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

Provider Enumeration Date	:	10/08/2009
Last Update Date	:	10/08/2009

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