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1164429627

NPI Code Detail

MEDICARE: DR. JOHN T COBB M.D.

MEDICARE: DR. JOHN T COBB M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207W00000X	Ophthalmology Physician	023577	GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
6	180025355	OTHER	GA	RR MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	0890552	OTHER	GA	UHC
3	294523	OTHER	GA	WELLCARE
4	480043	OTHER	GA	AETNA HMO
5	582209517	OTHER	GA	WORK COMP
7	1078920002	OTHER	GA	DME
8	814300	OTHER	GA	BCBS
9	02542	OTHER	GA	COVENTRY PPO
10	0818950001	OTHER	GA	DME
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
12	4030718	OTHER	GA	AETNA
13	5879	OTHER	GA	COVENTRY HMO
14	149418	OTHER	GA	BCBS

General Provider Information

NPI Number	:	1164429627
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN T COBB M.D.

Provider Business Mailing Address
First Line	:	5901A PEACHTREE DUNWOODY RD NE
Second Line	:	STE 500
City	:	ATLANTA
State	:	GA
Zip	:	30328-5382
Country	:	US
Telephone Number	:	678-892-2020
Fax Number	:	678-538-1950

Provider Business Practice Location Address
First Line	:	5995 BARFIELD RD
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-4411
Country	:	US
Telephone Number	:	404-256-1507
Fax Number	:	404-256-1981

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	09/24/2020

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Directions to “ DR. JOHN T COBB M.D.” Practice Location

Language	Start Address	Practice Location

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