Provider Demographics
NPI:1922125061
Name:TOBIN, WILLIAM DORAN (SPEECH PATHOLOGIST)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:DORAN
Last Name:TOBIN
Suffix:
Gender:M
Credentials:SPEECH PATHOLOGIST
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Mailing Address - Street 1:9 PLEASANT ST
Mailing Address - Street 2:MEDICINE ASSOCIATES LTD
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02906
Mailing Address - Country:US
Mailing Address - Phone:401-331-8555
Mailing Address - Fax:401-751-3512
Practice Address - Street 1:9 PLEASANT ST
Practice Address - Street 2:MEDICINE ASSOCIATES LTD
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02906
Practice Address - Country:US
Practice Address - Phone:401-331-8555
Practice Address - Fax:401-751-3512
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
RISP00020235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
234869OtherBLUE X
4600108OtherUNITED HEALTHCARE