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NPI Code Detail

MEDICARE: JASON D COBB MD LLC

MEDICARE: JASON D COBB MD LLC
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
1207X00000XOrthopaedic Surgery Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1102G708177OTHERALMEDICARE

General Provider Information

NPI Number : 1407225295
Entity Type Code : Organization
Provider Name (Legal Business Name) : JASON D COBB MD LLC
Provider Business Mailing Address
First Line : 7063 VETERANS PKWY
Second Line : STE 200
City : PELL CITY
State : AL
Zip : 35125-5114
Country : US
Telephone Number : 205-884-7700
Fax Number : 205-884-7602
Provider Business Practice Location Address
First Line : 7063 VETERANS PKWY
Second Line : STE 200
City : PELL CITY
State : AL
Zip : 35125-5114
Country : US
Telephone Number : 205-884-7700
Fax Number : 205-884-7602
Authorized Official
Title or Position : PRESIDENT
Name : DR. JASON D COBB
Credential : MD
Telephone Number : 205-884-7700
Provider Enumeration Date : 09/22/2015
Last Update Date : 09/22/2015

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