Provider Demographics
NPI:1790386829
Name:DOBY, RACHEL WALLACE (PA)
Entity type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:WALLACE
Last Name:DOBY
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:FAISON
Mailing Address - State:NC
Mailing Address - Zip Code:28341-0187
Mailing Address - Country:US
Mailing Address - Phone:910-267-2057
Mailing Address - Fax:855-996-9090
Practice Address - Street 1:2807 S HORNER BLVD
Practice Address - Street 2:
Practice Address - City:SANFORD
Practice Address - State:NC
Practice Address - Zip Code:27332-8037
Practice Address - Country:US
Practice Address - Phone:984-251-1331
Practice Address - Fax:984-201-1163
Is Sole Proprietor?:No
Enumeration Date:2020-11-04
Last Update Date:2024-12-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC0010-11050363A00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program