Basic Information
| Provider Information | |||||||||
| NPI: | 1629086368 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BOBBE | ||||||||
| FirstName: | DOROTHY | ||||||||
| MiddleName: | JEANNE | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 602373 | ||||||||
| Address2: | |||||||||
| City: | CHARLOTTE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 282602373 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8282131500 | ||||||||
| FaxNumber: | 8286516576 | ||||||||
| Practice Location | |||||||||
| Address1: | 189 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | SPRUCE PINE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287773035 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8287663555 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2006 | ||||||||
| LastUpdateDate: | 10/04/2016 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 35842 | NC | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 07673 | 01 | NC | BLUE CROSS PHYSICIAN | OTHER | 235013 | 01 | NC | MEDICARE PHYSICIAN | OTHER | 014MX | 01 | NC | BLUE CROSS LABS | OTHER | 235013B | 01 | NC | MEDICARE PHYSICIAN | OTHER | 34U011 | 01 | NC | MEDICARE SWINGBED | OTHER | 8907673 | 01 | NC | MEDICAID | OTHER | 8916398 | 05 | NC | MEDICAID | 00513 | 01 | NC | BLUE CROSS | OTHER | 16398 | 01 | NC | BCBS INDIVIDUAL PROVIDER | OTHER | 3400011 | 01 | NC | MEDICAID | OTHER | 411013849 | 01 | NC | RAILROAD MEDICARE | OTHER |