Provider Demographics
NPI:1316161581
Name:DOBYNS, PERRY THOMAS (MD)
Entity type:Individual
Prefix:
First Name:PERRY
Middle Name:THOMAS
Last Name:DOBYNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:PERRIN
Other - Middle Name:THOMAS
Other - Last Name:DOBYNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1547 OHIO AVE
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46016-1917
Mailing Address - Country:US
Mailing Address - Phone:765-641-7499
Mailing Address - Fax:765-641-0256
Practice Address - Street 1:1547 OHIO AVE
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016-1917
Practice Address - Country:US
Practice Address - Phone:765-641-7499
Practice Address - Fax:765-641-0256
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01056477A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine