Provider Demographics
NPI:1023845476
Name:HOBBS, REGINALD
Entity type:Individual
Prefix:
First Name:REGINALD
Middle Name:
Last Name:HOBBS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4074 COAL SPRING LN APT 3B
Mailing Address - Street 2:
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23060-4369
Mailing Address - Country:US
Mailing Address - Phone:804-822-0864
Mailing Address - Fax:
Practice Address - Street 1:4074 COAL SPRING LN APT 3B
Practice Address - Street 2:
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23060-4369
Practice Address - Country:US
Practice Address - Phone:804-822-0864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-09-18
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAB69817663172A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172A00000XOther Service ProvidersDriver