Provider Demographics
NPI:1902847718
Name:LOBB, ROBERT S (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:S
Last Name:LOBB
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 1:660 SHOSHONE ST E
Mailing Address - Street 2:SUITE 130
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-6110
Mailing Address - Country:US
Mailing Address - Phone:208-732-3200
Mailing Address - Fax:208-732-3300
Practice Address - Street 1:660 SHOSHONE ST E
Practice Address - Street 2:SUITE 130
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-6110
Practice Address - Country:US
Practice Address - Phone:208-732-3200
Practice Address - Fax:208-732-3300
Is Sole Proprietor?:No
Enumeration Date:2006-06-10
Last Update Date:2008-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM3584207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IDP00029393OtherRR MEDICARE
ID1111479Medicare ID - Type UnspecifiedMEDICARE NUMBER
IDP00029393OtherRR MEDICARE