Provider Demographics
NPI:1316979669
Name:DOBSON, STEPHEN J (D C)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:J
Last Name:DOBSON
Suffix:
Gender:M
Credentials:D C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 BEECH ST
Mailing Address - Street 2:
Mailing Address - City:HACKENSACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07601-2114
Mailing Address - Country:US
Mailing Address - Phone:201-489-1158
Mailing Address - Fax:201-489-1228
Practice Address - Street 1:301 BEECH ST
Practice Address - Street 2:
Practice Address - City:HACKENSACK
Practice Address - State:NJ
Practice Address - Zip Code:07601-2114
Practice Address - Country:US
Practice Address - Phone:201-489-1158
Practice Address - Fax:201-489-1228
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00336500111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ223592021OtherID NUMBER
NJDO440704Medicare ID - Type Unspecified