Provider Demographics
NPI:1336129253
Name:FINE, BOBBIE DEAN JR (MD)
Entity type:Individual
Prefix:DR
First Name:BOBBIE
Middle Name:DEAN
Last Name:FINE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:115 WRIGHTS ST
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71913-6240
Mailing Address - Country:US
Mailing Address - Phone:501-321-9803
Mailing Address - Fax:501-321-0710
Practice Address - Street 1:115 WRIGHTS ST
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71913-6240
Practice Address - Country:US
Practice Address - Phone:501-321-9803
Practice Address - Fax:501-321-0710
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2012-07-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARN8081207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR390001929OtherRRMEDICARE
AR118876001Medicaid
AR54494Medicare PIN
AR118876001Medicaid