Basic Information
| Provider Information | |||||||||
| NPI: | 1396281069 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HOBBS | ||||||||
| FirstName: | JUSTIN | ||||||||
| MiddleName: | LYLE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PT, DPT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 WOODGREEN PL | ||||||||
| Address2: | #101 | ||||||||
| City: | MADISON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 391108161 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 1 WOODGREEN PL | ||||||||
| Address2: | #101 | ||||||||
| City: | MADISON | ||||||||
| State: | MS | ||||||||
| PostalCode: | 391108161 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6016051126 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 01/18/2017 | ||||||||
| LastUpdateDate: | 01/18/2017 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | PT5519 | MS | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.