Healthcare Provider Details

I. General information

NPI: 1043376452
Provider Name (Legal Business Name): COBB HYPERBARIC MEDICINE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/29/2006
Last Update Date: 08/29/2022
Certification Date: 08/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 WHITCHER ST NE SUITE 2150
MARIETTA GA
30060-1176
US

IV. Provider business mailing address

1341 CANTON RD STE A
MARIETTA GA
30066-6056
US

V. Phone/Fax

Practice location:
  • Phone: 770-422-4268
  • Fax: 770-422-2950
Mailing address:
  • Phone: 770-422-0517
  • Fax: 678-638-7015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM2500X
TaxonomyMedical Specialty Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2083P0011X
TaxonomyUndersea and Hyperbaric Medicine (Preventive Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: HELEN B GELLY
Title or Position: PRESIDENT
Credential: MD
Phone: 770-422-4268