Provider Demographics
NPI:1093302754
Name:DOBYNS, TOM EDGAR
Entity Type:Individual
Prefix:
First Name:TOM
Middle Name:EDGAR
Last Name:DOBYNS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2690 PRESTWICK VILLAGE CIR
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45503-7121
Mailing Address - Country:US
Mailing Address - Phone:937-390-0078
Mailing Address - Fax:937-390-0078
Practice Address - Street 1:2696 PRESTWICK VILLAGE CIR
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45503-7121
Practice Address - Country:US
Practice Address - Phone:937-629-0669
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-29
Last Update Date:2020-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker