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General NPI Number Information
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NPI Number | 1407026818
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Entity Type | Individual
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Provider Name | JASON COBB MD
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Gender | Male
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Dates
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Enumeration Date | 03/03/2008
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Last Update Date | 02/19/2019
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Provider Practice Location Address
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Address Line | 550 PEACHTREE STREET MOT 7TH FLOOR NEPHROLOGY
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City | ATLANTA
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State | GA
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Zip | 30308
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Country | US
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Telephone | 404-686-5038
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Fax | 404-686-4995
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Provider Business Mailing Address
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Address Line | 1634 PONCE DE LEON AVE NE UNIT 107
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City | ATLANTA
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State | GA
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Zip | 30307-1626
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Country | US
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Telephone | 404-281-5076
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 65750
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License Number State | GA
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