Provider Demographics
NPI:1922052760
Name:HOBBS, CRIT (MD)
Entity Type:Individual
Prefix:DR
First Name:CRIT
Middle Name:
Last Name:HOBBS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:313 W. COUNTRY CLUB RD
Mailing Address - Street 2:SUITE #15
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201
Mailing Address - Country:US
Mailing Address - Phone:505-623-8021
Mailing Address - Fax:505-623-0193
Practice Address - Street 1:313 W. COUNTRY CLUB RD
Practice Address - Street 2:SUITE #15
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88201
Practice Address - Country:US
Practice Address - Phone:505-623-8021
Practice Address - Fax:505-623-0193
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM78-180207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM21105Medicaid
NMC-97838Medicare UPIN