Provider Demographics
NPI:1356391064
Name:LOBINS, RAYMOND LESLIE (DO)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:LESLIE
Last Name:LOBINS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9007
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65808-9007
Mailing Address - Country:US
Mailing Address - Phone:417-875-3000
Mailing Address - Fax:
Practice Address - Street 1:3850 S NATIONAL AVE
Practice Address - Street 2:SUITE 520
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65807-5287
Practice Address - Country:US
Practice Address - Phone:417-875-2607
Practice Address - Fax:417-875-2674
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2016004010207RH0003X, 207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200029644Medicaid
OH02685447Medicaid
MO200029644Medicaid
OH02685447Medicaid
OHP01050157Medicare PIN
OH2685447Medicaid