Provider Demographics
NPI:1477577880
Name:DOBSON, CHESTER K
Entity Type:Individual
Prefix:MR
First Name:CHESTER
Middle Name:K
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 1:1661 CANAL ST
Mailing Address - Street 2:SUITE 3140
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70112-2861
Mailing Address - Country:US
Mailing Address - Phone:504-310-0442
Mailing Address - Fax:504-310-0414
Practice Address - Street 1:1661 CANAL ST
Practice Address - Street 2:SUITE 3140
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70112-2861
Practice Address - Country:US
Practice Address - Phone:504-310-0442
Practice Address - Fax:504-310-4014
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-27
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA5564200001Medicare PIN