Provider Demographics
NPI:1336134501
Name:COBB, PETER F (MD)
Entity Type:Individual
Prefix:MR
First Name:PETER
Middle Name:F
Last Name:COBB
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:300 STONECREST BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-5688
Mailing Address - Country:US
Mailing Address - Phone:615-223-9502
Mailing Address - Fax:615-223-9596
Practice Address - Street 1:300 STONECREST BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SMYRNA
Practice Address - State:TN
Practice Address - Zip Code:37167-5688
Practice Address - Country:US
Practice Address - Phone:615-223-9502
Practice Address - Fax:615-223-9596
Is Sole Proprietor?:No
Enumeration Date:2005-09-14
Last Update Date:2022-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TNMD35401207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3866353Medicaid
TNH07974Medicare UPIN
TN3866353Medicaid
P00106072Medicare PIN