Provider Demographics
NPI:1013908193
Name:HOBBS, HARLEN DUANE II (DDS)
Entity type:Individual
Prefix:DR
First Name:HARLEN
Middle Name:DUANE
Last Name:HOBBS
Suffix:II
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:488 HURRICANE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:TN
Mailing Address - Zip Code:37352-5607
Mailing Address - Country:US
Mailing Address - Phone:931-588-5149
Mailing Address - Fax:
Practice Address - Street 1:18 S SPRING ST
Practice Address - Street 2:
Practice Address - City:SPARTA
Practice Address - State:TN
Practice Address - Zip Code:38583-1825
Practice Address - Country:US
Practice Address - Phone:931-836-2416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-29
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS76541223G0001X
IDD40941223G0001X
WADE000111651223G0001X
NMDD32491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID806590100Medicaid
TNQ020510Medicaid