Provider Demographics
NPI:1285621409
Name:DOBBS, CAROLYN LEE (MD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:LEE
Last Name:DOBBS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 WEST BLVD
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35206-1300
Mailing Address - Country:US
Mailing Address - Phone:205-591-5180
Mailing Address - Fax:205-510-3476
Practice Address - Street 1:601 WEST BLVD
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35206-1300
Practice Address - Country:US
Practice Address - Phone:205-591-5180
Practice Address - Fax:205-510-3476
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2010-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00015994207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL303709258Medicaid
AL113214Medicaid
ALG588OtherMEDICARE GROUP NUMBER ,
AL051516632OtherBLUE CROSS BLUE SHIELD
AL113214Medicaid
ALF60004Medicare UPIN