Jackson Randolph Dobbins, PA/C
Individual provider Active NPI Physician Assistant · Black Mountain, NC
NPI 1093709131 · NPPES record last updated Dec 9, 2015
Key facts
- NPI
- 1093709131
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 0010-02013 (NC)
- Practice address
- 3164 US Highway 70
Black Mountain, NC 28711-6302 - Phone
- (828) 669-4505
- Fax
- (828) 669-5112
- NPI assigned
- Sep 6, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0010-02013 | NC | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Raleigh Durham Medical Group PA | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 0010-02013 | NC | Yes |
Addresses
Primary practice location
3164 US Highway 70
Black Mountain, NC 28711-6302
Mailing address
23 Red Robin Way
Marion, NC 28752-4158
Phone (781) 507-3284
Other providers in Black Mountain, NC
- Salvatore John D'Angio
- Mary Elizabeth Daniel
- Marc Carl Debell
- Deborah G. Anders, DDS, PA
- Kathleen R Dine
- Doctors Vision Center OD PA
- Dogwood Senior Care LLC
- Janice Leigh Donnell
- Diane S Douglas
- Dr Christina Smith Optometrist PA
All providers in Black Mountain, NC · Physician Assistant in North Carolina
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 9, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.