Provider Demographics
NPI:1891828521
Name:NOBBS, BRIAN (DC)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:
Last Name:NOBBS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5984 WOODTHRUSH LN
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-5928
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1755 S ERIE HWY
Practice Address - Street 2:SUITE A
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45011-4144
Practice Address - Country:US
Practice Address - Phone:513-896-9355
Practice Address - Fax:513-896-3874
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2018111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000019134OtherANTHEM BLUE CROSS BLUE SH
OH2018COtherHUMANA AMERICAN WHOLE HEA
OH44-81033OtherUNITED HEALTHCARE
OH155193Medicaid
OHNO0788061Medicare ID - Type UnspecifiedPALMETTO GBA
OH155193Medicaid