Provider Demographics
NPI:1275796229
Name:DOBBINS, KEVIN LOUIS (OD)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:LOUIS
Last Name:DOBBINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2002 PROFESSIONAL CT
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25401-8808
Mailing Address - Country:US
Mailing Address - Phone:304-267-4273
Mailing Address - Fax:304-267-2135
Practice Address - Street 1:2002 PROFESSIONAL CT
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25401-8808
Practice Address - Country:US
Practice Address - Phone:304-267-4273
Practice Address - Fax:304-267-2135
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA2095152W00000X
WV3047-IOD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD018629500Medicaid
MD127170YMBXMedicare PIN