Provider Demographics
NPI:1376583351
Name:HOBSON, ROBERT BRUCE (PSYD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:BRUCE
Last Name:HOBSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1910 S VIRGINIA ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOPKINSVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42240-3692
Mailing Address - Country:US
Mailing Address - Phone:270-889-9200
Mailing Address - Fax:270-889-9911
Practice Address - Street 1:1910 S VIRGINIA ST
Practice Address - Street 2:SUITE 200
Practice Address - City:HOPKINSVILLE
Practice Address - State:KY
Practice Address - Zip Code:42240-3692
Practice Address - Country:US
Practice Address - Phone:270-889-9200
Practice Address - Fax:270-889-9911
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY-0517103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA000000210821OtherANTHEM PROVIDER NUMBER
LA7552223OtherAETNA PROVIDER NUMBER
TN4035796OtherBCBST PROVIDER NUMBER
LA6123793OtherUBH PROVIDER NUMBER
KY08490000OtherMAGELLAN PROVIDER NUMBER
KYS885545Medicare UPIN