Provider Demographics
NPI:1851464580
Name:NOBLES, ROSSIE DAWN (MD)
Entity type:Individual
Prefix:
First Name:ROSSIE
Middle Name:DAWN
Last Name:NOBLES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 365
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-0365
Mailing Address - Country:US
Mailing Address - Phone:910-642-9850
Mailing Address - Fax:910-642-9852
Practice Address - Street 1:810 SPIVEY RD
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-8736
Practice Address - Country:US
Practice Address - Phone:910-642-9850
Practice Address - Fax:910-642-9852
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9800341207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891268GMedicaid
NC891268GMedicaid
H19496Medicare UPIN