Individual
GLENN LEE DOBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1205 HADLEY RD, MOORESVILLE, IN 46158-1789
(317) 584-3454
(317) 584-3435
Mailing address
8051 S. EMERSON AVENUE, #400, INDIANAPOLIS, IN 46237-8633
(317) 865-3600
(317) 865-3850
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
02001767A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000576533
ANTHEM PROVIDER #
IN
05
—
200105500
—
IN
Enumeration date
07/11/2006
Last updated
09/14/2012
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