MEDICARE: MICHAEL E COBBLE

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	207Q00000X	Family Medicine Physician	262586-1205	UT

General Provider Information

NPI Number	:	1992927834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL E COBBLE

Provider Business Mailing Address
First Line	:	9355 S 1300 E
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84094-3135
Country	:	US
Telephone Number	:	801-572-1616
Fax Number	:	801-572-3106

Provider Business Practice Location Address
First Line	:	9355 S 1300 E
Second Line	:
City	:	SANDY
State	:	UT
Zip	:	84094-3135
Country	:	US
Telephone Number	:	801-572-1616
Fax Number	:	801-572-3106

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

Provider Enumeration Date	:	05/02/2007
Last Update Date	:	03/10/2014

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Directions to “ MICHAEL E COBBLE ” Practice Location

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