Provider Demographics
NPI:1578181178
Name:K AND C COBB MDS LLC
Entity Type:Organization
Organization Name:K AND C COBB MDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:
Authorized Official - First Name:CARRIE
Authorized Official - Middle Name:
Authorized Official - Last Name:COBB
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:434-947-5321
Mailing Address - Street 1:2007 TATE SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:LYNCHBURG
Mailing Address - State:VA
Mailing Address - Zip Code:24501-1111
Mailing Address - Country:US
Mailing Address - Phone:434-947-5321
Mailing Address - Fax:434-947-5324
Practice Address - Street 1:2007 TATE SPRINGS RD
Practice Address - Street 2:
Practice Address - City:LYNCHBURG
Practice Address - State:VA
Practice Address - Zip Code:24501-1111
Practice Address - Country:US
Practice Address - Phone:434-947-5321
Practice Address - Fax:434-947-5324
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-09
Last Update Date:2020-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatologyGroup - Single Specialty