Provider Demographics
NPI:1235160847
Name:COBB, JASON DOUGLAS (MD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:DOUGLAS
Last Name:COBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1015 MEDICAL CENTER PKWY
Mailing Address - Street 2:
Mailing Address - City:SELMA
Mailing Address - State:AL
Mailing Address - Zip Code:36701-6748
Mailing Address - Country:US
Mailing Address - Phone:334-418-4113
Mailing Address - Fax:
Practice Address - Street 1:1023 MEDICAL CENTER PKWY STE 201
Practice Address - Street 2:
Practice Address - City:SELMA
Practice Address - State:AL
Practice Address - Zip Code:36701-7737
Practice Address - Country:US
Practice Address - Phone:334-418-6642
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.32303207XX0801X
GA67549207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery