Provider Demographics
NPI:1477526481
Name:DOBIE, DAVID O (CRNA)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:O
Last Name:DOBIE
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 ANNABERG DR
Mailing Address - Street 2:
Mailing Address - City:YOUNGSVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70592-5740
Mailing Address - Country:US
Mailing Address - Phone:504-442-4393
Mailing Address - Fax:
Practice Address - Street 1:42570 S AIRPORT RD
Practice Address - Street 2:CYPRESS POINTE SURGICAL HOSPITAL
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70403-0946
Practice Address - Country:US
Practice Address - Phone:985-510-6135
Practice Address - Fax:985-510-6202
Is Sole Proprietor?:No
Enumeration Date:2006-02-09
Last Update Date:2023-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN094021367500000X
LAAP06330367500000X
TN10415367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3633612Medicaid
LA2132768Medicaid
MS09621814Medicaid
LA2132768Medicaid