Provider Demographics
NPI:1982687034
Name:HOBBS, KENNETH L (DPM)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:L
Last Name:HOBBS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:714 SW FAIRLAWN RD
Mailing Address - Street 2:
Mailing Address - City:TOPEKA
Mailing Address - State:KS
Mailing Address - Zip Code:66606-2539
Mailing Address - Country:US
Mailing Address - Phone:785-271-5176
Mailing Address - Fax:785-271-5178
Practice Address - Street 1:714 SW FAIRLAWN RD
Practice Address - Street 2:
Practice Address - City:TOPEKA
Practice Address - State:KS
Practice Address - Zip Code:66606-2539
Practice Address - Country:US
Practice Address - Phone:785-271-5176
Practice Address - Fax:785-271-5178
Is Sole Proprietor?:Yes
Enumeration Date:2005-11-22
Last Update Date:2011-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS12-00178213EP1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS481040751OtherTAX ID
KS4757380001Medicare NSC
KS006751Medicare PIN
KST77061Medicare UPIN