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General NPI Number Information
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NPI Number | 1700489697
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Entity Type | Individual
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Provider Name | JONATHAN THOMAS COBB MD
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Gender | Male
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Dates
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Enumeration Date | 11/21/2020
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Last Update Date | 07/26/2024
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Provider Practice Location Address
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Address Line | 1212 GARFIELD AVE STE 300
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City | PARKERSBURG
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State | WV
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Zip | 26101-3247
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Country | US
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Telephone | 304-865-3621
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Fax | 833-450-0628
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Provider Business Mailing Address
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Address Line | 1212 GARFIELD AVE STE 300
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City | PARKERSBURG
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State | WV
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Zip | 26101-3247
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Country | US
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Telephone | 304-865-3600
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Fax | 304-865-3700
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 33774
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License Number State | WV
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