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NPI Code Detail

MEDICARE: MARIE COBB PA-C

MEDICARE: MARIE COBB PA-C
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
1363AM0700XMedical Physician Assistant50-008015OH
2363A00000XPhysician Assistant50.008015OH

General Provider Information

NPI Number : 1871290270
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE COBB PA-C
Provider Business Mailing Address
First Line : 243 SANDERSON DR
Second Line :
City : DAYTON
State : OH
Zip : 45459-1908
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7707 PARAGON RD
Second Line :
City : CENTERVILLE
State : OH
Zip : 45459-4041
Country : US
Telephone Number : 937-208-6920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2023
Last Update Date : 08/12/2025

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Directions to “ MARIE COBB PA-C” Practice Location

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