Provider Demographics
NPI:1427457506
Name:HOBGOOD, KRISTOPHER CHAD (PHARMD)
Entity type:Individual
Prefix:MR
First Name:KRISTOPHER
Middle Name:CHAD
Last Name:HOBGOOD
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 BARBE ST
Mailing Address - Street 2:
Mailing Address - City:LAKE CHARLES
Mailing Address - State:LA
Mailing Address - Zip Code:70601-5747
Mailing Address - Country:US
Mailing Address - Phone:225-803-5463
Mailing Address - Fax:
Practice Address - Street 1:3451 NELSON RD
Practice Address - Street 2:
Practice Address - City:LAKE CHARLES
Practice Address - State:LA
Practice Address - Zip Code:70605-1209
Practice Address - Country:US
Practice Address - Phone:337-477-9831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-14
Last Update Date:2014-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA017717183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist