Provider Demographics
NPI:1154461465
Name:HOBBS, SEABORN ALLEN
Entity Type:Individual
Prefix:MR
First Name:SEABORN
Middle Name:ALLEN
Last Name:HOBBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:SEABORN
Other - Middle Name:ALLEN
Other - Last Name:HOBBS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ARNP
Mailing Address - Street 1:324 E. BEACH DR.
Mailing Address - Street 2:703
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32401-5810
Mailing Address - Country:US
Mailing Address - Phone:850-763-7544
Mailing Address - Fax:
Practice Address - Street 1:615 N. BONITA AVE
Practice Address - Street 2:
Practice Address - City:PANAMA CITY
Practice Address - State:FL
Practice Address - Zip Code:32401-3623
Practice Address - Country:US
Practice Address - Phone:850-769-1511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1924092367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG0379ZMedicare ID - Type Unspecified