Provider Demographics
NPI:1841288594
Name:JOHN M. HOBBS, JR., M.D., P.C.
Entity type:Organization
Organization Name:JOHN M. HOBBS, JR., M.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MERRION
Authorized Official - Last Name:HOBBS,
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:541-331-1631
Mailing Address - Street 1:PO BOX 1367
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48805-1367
Mailing Address - Country:US
Mailing Address - Phone:541-331-1631
Mailing Address - Fax:
Practice Address - Street 1:205 W DILL DR
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-8798
Practice Address - Country:US
Practice Address - Phone:541-331-1631
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-06
Last Update Date:2010-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14650207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
C92870Medicare UPIN