Provider Demographics
NPI:1710957741
Name:DABBS, RICHARD SPENCE (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:SPENCE
Last Name:DABBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1513 PEDIATRIC DR
Mailing Address - Street 2:
Mailing Address - City:JASPER
Mailing Address - State:AL
Mailing Address - Zip Code:35501-4059
Mailing Address - Country:US
Mailing Address - Phone:205-221-4780
Mailing Address - Fax:205-221-4783
Practice Address - Street 1:1513 PEDIATRIC DR
Practice Address - Street 2:
Practice Address - City:JASPER
Practice Address - State:AL
Practice Address - Zip Code:35501-4059
Practice Address - Country:US
Practice Address - Phone:205-221-4780
Practice Address - Fax:205-221-4783
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL10071208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
C76624Medicare UPIN