Provider Demographics
NPI:1790386829
Name:DOBY, RACHEL WALLACE (PA)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:WALLACE
Last Name:DOBY
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:185 DOBY RD
Mailing Address - Street 2:
Mailing Address - City:CAMERON
Mailing Address - State:NC
Mailing Address - Zip Code:28326-8185
Mailing Address - Country:US
Mailing Address - Phone:828-448-8957
Mailing Address - Fax:
Practice Address - Street 1:106 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:HAMLET
Practice Address - State:NC
Practice Address - Zip Code:28345-3100
Practice Address - Country:US
Practice Address - Phone:910-557-9447
Practice Address - Fax:888-226-0864
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-11050363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program