Provider Demographics
NPI:1376839373
Name:HOBBS, WHITNEY BASS (DPT/ATC)
Entity Type:Individual
Prefix:MS
First Name:WHITNEY
Middle Name:BASS
Last Name:HOBBS
Suffix:
Gender:F
Credentials:DPT/ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 FAIRVIEW PARK DR
Mailing Address - Street 2:P O BOX 883
Mailing Address - City:DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31021-2501
Mailing Address - Country:US
Mailing Address - Phone:478-272-7494
Mailing Address - Fax:478-272-2616
Practice Address - Street 1:101 FAIRVIEW PARK DR
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-2501
Practice Address - Country:US
Practice Address - Phone:478-272-7494
Practice Address - Fax:478-272-2616
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2015-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPT010303225100000X
GAAT0015942255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003112856EMedicaid
GA003112856AMedicaid
GA116544Medicare PIN