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General NPI Number Information
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NPI Number | 1972961845
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Entity Type | Organization
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Legal Business Name | COBB EYE ASSOCIATES I
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Dates
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Enumeration Date | 02/05/2016
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Last Update Date | 09/07/2016
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Provider Practice Location Address
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Address Line | 1785 COBB PKWY S
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City | MARIETTA
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State | GA
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Zip | 30060-9288
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Country | US
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Telephone | 770-955-5019
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Fax | 770-955-7349
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Provider Business Mailing Address
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Address Line | 1785 COBB PKWY S
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City | MARIETTA
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State | GA
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Zip | 30060-9288
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Country | US
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Telephone | 770-955-5019
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Fax | 770-955-7349
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Authorized Official
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Title or Position | DOCTOR
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Name | ANISHA HAJI
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Credential | OD
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Telephone | 470-725-6171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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