Provider Demographics
NPI:1063229458
Name:TWIN RIVERS MEDICAL PC
Entity type:Organization
Organization Name:TWIN RIVERS MEDICAL PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:W
Authorized Official - Last Name:DOBSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:802-447-4535
Mailing Address - Street 1:7 SOUTHWOODS BLVD
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12211-2514
Mailing Address - Country:US
Mailing Address - Phone:518-641-6580
Mailing Address - Fax:
Practice Address - Street 1:7 SOUTHWOODS BLVD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12211-2514
Practice Address - Country:US
Practice Address - Phone:518-641-6580
Practice Address - Fax:518-292-6088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-18
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Multi-Specialty