Basic Information
| Provider Information | |||||||||
| NPI: | 1801983325 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOBBS | ||||||||
| FirstName: | STEVEN | ||||||||
| MiddleName: | ALAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1550 COLLEGE ST | ||||||||
| Address2: | SUITE A | ||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 312070001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4783012397 | ||||||||
| FaxNumber: | 4783012128 | ||||||||
| Practice Location | |||||||||
| Address1: | 655 1ST ST | ||||||||
| Address2: | |||||||||
| City: | MACON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 312012852 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4783015930 | ||||||||
| FaxNumber: | 4783015932 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/06/2006 | ||||||||
| LastUpdateDate: | 09/21/2011 | ||||||||
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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 | 103TC0700X | PSY001317 | GA | Y | Behavioral Health & Social Service Providers | Psychologist | Clinical |
ID Information
| ID | Type | State | Issuer | Description | 000386251B | 05 | GA | MEDICAID |