# PHYSICIAN ASSIST LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1669702569
- **Authorized official:** MR. MICHAEL JOHN COBB PA-C (OWNER)
- **Authorized official phone:** (401) 265-4553

## Contact information

- **Practice address:** 35 BROAD ROCK RD, WAKEFIELD, RI 02879-1872
- **Practice address phone:** (401) 265-4553
- **Mailing address:** 35 BROAD ROCK RD, WAKEFIELD, RI 02879-1872
- **Mailing address phone:** (401) 265-4553

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363AS0400X | Surgical Physician Assistant | PA00255 | RI | Yes |

## Other

- **Enumeration date:** 12/28/2009
- **Last updated:** 12/28/2009