Provider Demographics
NPI:1821026931
Name:HOBBS, BEN L (OD)
Entity Type:Individual
Prefix:DR
First Name:BEN
Middle Name:L
Last Name:HOBBS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8180 SOUTH TRYON ST
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28273
Mailing Address - Country:US
Mailing Address - Phone:704-588-9219
Mailing Address - Fax:704-588-9219
Practice Address - Street 1:8180 SOUTH TRYON ST
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28273
Practice Address - Country:US
Practice Address - Phone:704-588-9219
Practice Address - Fax:704-588-9219
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1953152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89093R0Medicaid
NC017JJOtherBCBS GROUP ID#
NC093R0OtherBCBS INDIVIDUAL ID#
NC89093R0Medicaid
NCV02996Medicare UPIN
NC2341709Medicare ID - Type UnspecifiedMEDICARE GROUP ID#