Provider Demographics
NPI:1063512291
Name:COBB, ROBERT BRANSON JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:BRANSON
Last Name:COBB
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:ROBERT
Other - Middle Name:B
Other - Last Name:COBB
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2055 W HOSPITAL DR STE 175
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85704-7823
Mailing Address - Country:US
Mailing Address - Phone:520-575-6944
Mailing Address - Fax:520-575-1115
Practice Address - Street 1:2055 W HOSPITAL DR STE 175
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-7823
Practice Address - Country:US
Practice Address - Phone:520-575-6944
Practice Address - Fax:520-575-1115
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2011-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ11852207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z3097OtherHEALTHNET
AZAZ0025510OtherBLUE CROSS BLUE SHIELD
AZ207789-001Medicaid
AZ1Z3097OtherHEALTHNET
AZAZ0025510OtherBLUE CROSS BLUE SHIELD