Provider Demographics
NPI:1750398186
Name:DOBSON, JOHN WILLIAM (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:WILLIAM
Last Name:DOBSON
Suffix:
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 1:2330 E HIGH ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:45505-1371
Mailing Address - Country:US
Mailing Address - Phone:937-325-2663
Mailing Address - Fax:937-325-9826
Practice Address - Street 1:1711 27TH ST STE 102
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:OH
Practice Address - Zip Code:45662-2657
Practice Address - Country:US
Practice Address - Phone:740-356-1709
Practice Address - Fax:740-353-3027
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2019-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35050522D207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0560521Medicaid
OH010017050OtherRAILROAD MEDICARE
OHD89576Medicare UPIN
OH010017050OtherRAILROAD MEDICARE