Provider Demographics
NPI:1326179136
Name:DOBOSH, WILLIAM JAMES
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:JAMES
Last Name:DOBOSH
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 1:147 CREED ST
Mailing Address - Street 2:
Mailing Address - City:HUBBARD
Mailing Address - State:OH
Mailing Address - Zip Code:44425-2114
Mailing Address - Country:US
Mailing Address - Phone:330-534-9150
Mailing Address - Fax:
Practice Address - Street 1:141 CREED ST
Practice Address - Street 2:
Practice Address - City:HUBBARD
Practice Address - State:OH
Practice Address - Zip Code:44425-2114
Practice Address - Country:US
Practice Address - Phone:330-534-1701
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH7800446Medicaid