Provider Demographics
NPI:1508805706
Name:DOBBINS, JAMES G (MD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:G
Last Name:DOBBINS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19400 D DR. S
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:MI
Mailing Address - Zip Code:49068-1497
Mailing Address - Country:US
Mailing Address - Phone:269-781-9867
Mailing Address - Fax:269-781-9126
Practice Address - Street 1:19400 D DR. S
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:MI
Practice Address - Zip Code:49068-1497
Practice Address - Country:US
Practice Address - Phone:269-781-9867
Practice Address - Fax:269-781-9126
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-05
Last Update Date:2009-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301033872207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1331367Medicaid
MIB44377Medicare UPIN
MIOA36038004Medicare ID - Type Unspecified