Provider Demographics
NPI:1710337381
Name:DOBBE, IAN
Entity Type:Individual
Prefix:
First Name:IAN
Middle Name:
Last Name:DOBBE
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 1:400 HOBART ST
Mailing Address - Street 2:C/O HEATHER BYERS
Mailing Address - City:CADILLAC
Mailing Address - State:MI
Mailing Address - Zip Code:49601-2331
Mailing Address - Country:US
Mailing Address - Phone:231-876-7807
Mailing Address - Fax:231-876-7176
Practice Address - Street 1:3100 TONGASS AVE
Practice Address - Street 2:
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901-5746
Practice Address - Country:US
Practice Address - Phone:907-228-5171
Practice Address - Fax:907-228-8335
Is Sole Proprietor?:No
Enumeration Date:2016-06-15
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301109401207Q00000X
AK146579207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine