Provider Demographics
NPI:1942987037
Name:HOBSON, JERICHO LYNN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JERICHO
Middle Name:LYNN
Last Name:HOBSON
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12401 E 76TH PL N
Mailing Address - Street 2:
Mailing Address - City:OWASSO
Mailing Address - State:OK
Mailing Address - Zip Code:74055-7906
Mailing Address - Country:US
Mailing Address - Phone:918-704-4495
Mailing Address - Fax:
Practice Address - Street 1:12401 E 76TH PL N
Practice Address - Street 2:
Practice Address - City:OWASSO
Practice Address - State:OK
Practice Address - Zip Code:74055-7906
Practice Address - Country:US
Practice Address - Phone:918-704-4495
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-29
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist