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NPI Code Detail

MEDICARE: NICHOLAS BLAKE COBB MD

MEDICARE: NICHOLAS BLAKE COBB MD
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
1207Q00000XFamily Medicine Physician61194TN

General Provider Information

NPI Number : 1831696822
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICHOLAS BLAKE COBB MD
Provider Business Mailing Address
First Line : 975 E 3RD ST
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37403-2163
Country : US
Telephone Number : 423-778-7977
Fax Number :
Provider Business Practice Location Address
First Line : 975 E 3RD ST
Second Line :
City : CHATTANOOGA
State : TN
Zip : 37403-2163
Country : US
Telephone Number : 423-778-7977
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/07/2018
Last Update Date : 06/29/2021

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Directions to “ NICHOLAS BLAKE COBB MD” Practice Location

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