Provider Demographics
NPI:1003075946
Name:COBBETT, LINDSEY E (MD)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:E
Last Name:COBBETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1991 SPROUL RD STE 200
Mailing Address - Street 2:
Mailing Address - City:BROOMALL
Mailing Address - State:PA
Mailing Address - Zip Code:19008-3518
Mailing Address - Country:US
Mailing Address - Phone:610-325-0309
Mailing Address - Fax:610-325-0459
Practice Address - Street 1:1991 SPROUL RD STE 200
Practice Address - Street 2:
Practice Address - City:BROOMALL
Practice Address - State:PA
Practice Address - Zip Code:19008
Practice Address - Country:US
Practice Address - Phone:610-325-0309
Practice Address - Fax:610-325-0459
Is Sole Proprietor?:No
Enumeration Date:2008-06-05
Last Update Date:2019-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD451200207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA23-2359401OtherMAIN LINE HEALTHCARE TAX ID
NY04218948Medicaid
PA23-2359401OtherMAIN LINE HEALTHCARE TAX ID