Provider Demographics
NPI:1003966045
Name:HOBAUGH, MICHAEL R (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:R
Last Name:HOBAUGH
Suffix:
Gender:M
Credentials:MD, PHD
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Mailing Address - Street 1:1330 OAKRIDGE DR., STE 100
Mailing Address - Street 2:PEDIATRIC ASSOCIATES OF NORTHERN COLORADO
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80525
Mailing Address - Country:US
Mailing Address - Phone:970-484-4871
Mailing Address - Fax:970-482-4927
Practice Address - Street 1:1330 OAKRIDGE DR., STE 100
Practice Address - Street 2:PEDIATRIC ASSOCIATES OF NORTHERN COLORADO
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80525
Practice Address - Country:US
Practice Address - Phone:970-484-4871
Practice Address - Fax:970-482-4927
Is Sole Proprietor?:No
Enumeration Date:2007-01-11
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CODR.0056036208000000X
IL0361061272080N0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080N0001XAllopathic & Osteopathic PhysiciansPediatricsNeonatal-Perinatal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036106127Medicaid
IL036106127Medicaid