Provider Demographics
NPI:1962589846
Name:COBB, JOHN (AUD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:COBB
Suffix:
Gender:M
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 E WHITEHOUSE CANYON RD
Mailing Address - Street 2:SUITE 196
Mailing Address - City:GREEN VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85614-0550
Mailing Address - Country:US
Mailing Address - Phone:520-648-3277
Mailing Address - Fax:
Practice Address - Street 1:512 E WHITEHOUSE CANYON RD
Practice Address - Street 2:SUITE 196
Practice Address - City:GREEN VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85614-0550
Practice Address - Country:US
Practice Address - Phone:520-648-3277
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2009-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZDA6213231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist