Provider Demographics
NPI:1063287191
Name:DUGGER, BOBBY LEE JR
Entity type:Individual
Prefix:
First Name:BOBBY
Middle Name:LEE
Last Name:DUGGER
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57750 BLAKE CT
Mailing Address - Street 2:
Mailing Address - City:LENOX
Mailing Address - State:MI
Mailing Address - Zip Code:48048-3149
Mailing Address - Country:US
Mailing Address - Phone:586-649-8054
Mailing Address - Fax:
Practice Address - Street 1:57750 BLAKE CT
Practice Address - Street 2:
Practice Address - City:LENOX
Practice Address - State:MI
Practice Address - Zip Code:48048-3149
Practice Address - Country:US
Practice Address - Phone:586-649-8054
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide