Provider Demographics
NPI:1356597983
Name:MOBLEY, JOE DICK III (MD)
Entity type:Individual
Prefix:
First Name:JOE
Middle Name:DICK
Last Name:MOBLEY
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1002 CORNERSTONE DR.
Mailing Address - Street 2:SUITE A
Mailing Address - City:PARIS
Mailing Address - State:TN
Mailing Address - Zip Code:38242
Mailing Address - Country:US
Mailing Address - Phone:731-642-8884
Mailing Address - Fax:731-642-8865
Practice Address - Street 1:1002 CORNERSTONE DR.
Practice Address - Street 2:SUITE A
Practice Address - City:PARIS
Practice Address - State:TN
Practice Address - Zip Code:38242
Practice Address - Country:US
Practice Address - Phone:731-642-8884
Practice Address - Fax:731-642-8865
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-14
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN47054174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist