Provider Demographics
NPI:1366003725
Name:DOBSON, JEROME
Entity Type:Individual
Prefix:
First Name:JEROME
Middle Name:
Last Name:DOBSON
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 1:63 FOUNTAIN ST STE 503
Mailing Address - Street 2:
Mailing Address - City:FRAMINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01702-6279
Mailing Address - Country:US
Mailing Address - Phone:508-875-9529
Mailing Address - Fax:
Practice Address - Street 1:63 FOUNTAIN ST STE 503
Practice Address - Street 2:
Practice Address - City:FRAMINGHAM
Practice Address - State:MA
Practice Address - Zip Code:01702-6279
Practice Address - Country:US
Practice Address - Phone:508-875-9529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2019-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist