MEDICARE: DR. JAMES MICHAEL 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	207R00000X	Internal Medicine Physician	029609	GA

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

General Provider Information

NPI Number	:	1336134477
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES MICHAEL COBB M.D.

Provider Business Mailing Address
First Line	:	PO BOX 409
Second Line	:
City	:	WATKINSVILLE
State	:	GA
Zip	:	30677-0011
Country	:	US
Telephone Number	:	706-769-6469
Fax Number	:	706-769-4402

Provider Business Practice Location Address
First Line	:	129 MAIN ST
Second Line	:
City	:	BOGART
State	:	GA
Zip	:	30622-1566
Country	:	US
Telephone Number	:	770-725-7420
Fax Number	:	770-725-5578

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	12/09/2009

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