Provider Demographics
NPI:1356317499
Name:DOBBINS, KENDALL R (MD)
Entity Type:Individual
Prefix:DR
First Name:KENDALL
Middle Name:R
Last Name:DOBBINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:16 WOODBINE LN
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17821-8029
Practice Address - Country:US
Practice Address - Phone:570-271-6531
Practice Address - Fax:570-271-7146
Is Sole Proprietor?:No
Enumeration Date:2006-02-28
Last Update Date:2020-08-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAMD418143207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001885703Medicaid
PA054574Medicare ID - Type Unspecified