Provider Demographics
NPI:1578683983
Name:COBB, JAMES A (DC, DOM)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:A
Last Name:COBB
Suffix:
Gender:M
Credentials:DC, DOM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1214 HICKOX ST
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-1028
Mailing Address - Country:US
Mailing Address - Phone:505-986-0887
Mailing Address - Fax:
Practice Address - Street 1:1214 HICKOX ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-1028
Practice Address - Country:US
Practice Address - Phone:505-986-0887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1159111N00000X
NM278171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered111N00000XChiropractic ProvidersChiropractor
Not Answered171100000XOther Service ProvidersAcupuncturist