Provider Demographics
NPI:1518439462
Name:DOBBS, PAUL W (APRN)
Entity Type:Individual
Prefix:MR
First Name:PAUL
Middle Name:W
Last Name:DOBBS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 DODSON AVE
Mailing Address - Street 2:
Mailing Address - City:FORT SMITH
Mailing Address - State:AR
Mailing Address - Zip Code:72901-5182
Mailing Address - Country:US
Mailing Address - Phone:479-709-7325
Mailing Address - Fax:
Practice Address - Street 1:5700 PHOENIX PL
Practice Address - Street 2:
Practice Address - City:FORT SMITH
Practice Address - State:AR
Practice Address - Zip Code:72903-5782
Practice Address - Country:US
Practice Address - Phone:794-441-2601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-12-17
Last Update Date:2023-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA006002363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner