Mark John Dobson, D.C
Individual provider Active NPI Sports Physician Chiropractor · Demotte, IN
NPI 1083765259 · NPPES record last updated Apr 17, 2008
Key facts
- NPI
- 1083765259
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Sports Physician Chiropractor 111NS0005X
- License
- 08001363 (IN)
- Practice address
- 5529 W State Road 10
Demotte, IN 46310-8799 - Phone
- (219) 987-7746
- Fax
- (219) 987-7749
- NPI assigned
- Jan 15, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Chiropractic
- Education
- Other, 1991
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5844 W State Rd
Suite 10
Demotte, IN 46310-9498
Phone (219) 987-7746
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050316000207 | IN | Practitioner - Chiropractic | 6103871116 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08001363 | IN | MD | Sports Physician Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dobson Chiropractic Center PC | Sports Physician | Current |
Accepting new patients |
Locations
5529 W State Road 10
Demotte, IN 46310
Phone (219) 987-7333
5844 W State Road 10
Demotte, IN 46310
Phone (219) 987-7746
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Sports Physician Chiropractor | 111NS0005X | 08001363 | IN | Yes |
Addresses
Primary practice location
5529 W State Road 10
Demotte, IN 46310-8799
Mailing address
5529 W State Road 10
Demotte, IN 46310-8799
Phone (219) 987-7746
Other providers in Demotte, IN
- Gerrit H. Devries
- Judy C Dewitt
- Carman Lashawn Dobbins
- Carly Dobin
- Dobson Chiropractic Center PC
- Dodi R. Woolley DDS, Inc
- Demiana Elgendi
- Donabelle Reyes Eliscupides
- Miranda Louise Faris
- Arsenio Santiago Favor
All providers in Demotte, IN · Sports Physician Chiropractor in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.