Provider Demographics
NPI:1386870376
Name:COBB, JASON MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:JASON
Middle Name:MICHAEL
Last Name:COBB
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:5110 E SOUTHERN AVE STE 107
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-2790
Mailing Address - Country:US
Mailing Address - Phone:480-295-8072
Mailing Address - Fax:415-252-7176
Practice Address - Street 1:5110 E SOUTHERN AVE STE 107
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85206-2790
Practice Address - Country:US
Practice Address - Phone:480-295-8072
Practice Address - Fax:415-252-7176
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NMMD2012-0165207R00000X
ORLL18732207R00000X
AZ71554207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine