Provider Demographics
NPI:1710966650
Name:COBLER, JO ANNE L (MD)
Entity Type:Individual
Prefix:
First Name:JO ANNE
Middle Name:L
Last Name:COBLER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:425 ESSJAY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8235
Mailing Address - Country:US
Mailing Address - Phone:716-630-1219
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:325 ESSJAY RD
Practice Address - Street 2:BUFFALO MEDICAL GROUP, PC
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-8243
Practice Address - Country:US
Practice Address - Phone:716-630-1146
Practice Address - Fax:716-817-1727
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY158561207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010033201OtherUNIVERA
NY000510604001OtherBLUE CROSS/COMMUNITY BLUE
NY1084844Medicaid
NY2102706OtherINDEPENDENT HEALTH
NY000510604001OtherBLUE CROSS/COMMUNITY BLUE
NYG67171Medicare ID - Type Unspecified