MEDICARE: MR. JASON LLOYD COBB OTA

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	224Z00000X	Occupational Therapy Assistant

General Provider Information

NPI Number	:	1952251597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JASON LLOYD COBB OTA

Provider Business Mailing Address
First Line	:	6215 HAAG ST APT A
Second Line	:
City	:	FORT POLK
State	:	LA
Zip	:	71459-7411
Country	:	US
Telephone Number	:	726-780-2592
Fax Number	:

Provider Business Practice Location Address
First Line	:	6215 HAAG ST APT A
Second Line	:
City	:	FORT POLK
State	:	LA
Zip	:	71459-7411
Country	:	US
Telephone Number	:	726-780-2592
Fax Number	:

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

Provider Enumeration Date	:	02/02/2026
Last Update Date	:	02/02/2026

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