Provider Demographics
NPI:1467421073
Name:HOBSON, CHRIS (OD)
Entity Type:Individual
Prefix:MR
First Name:CHRIS
Middle Name:
Last Name:HOBSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 WOOTEN LAKE RD NW
Mailing Address - Street 2:SUITE 100
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144-1350
Mailing Address - Country:US
Mailing Address - Phone:770-424-2020
Mailing Address - Fax:770-424-8242
Practice Address - Street 1:1415 WOOTEN LAKE RD NW
Practice Address - Street 2:SUITE 100
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144-1350
Practice Address - Country:US
Practice Address - Phone:770-424-2020
Practice Address - Fax:770-424-8242
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-16
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT000797152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000230392BMedicaid
GA000230392BMedicaid
GA41ZCFFWMedicare ID - Type Unspecified
GAU22306Medicare UPIN