Individual
JAMIE JAKIA COSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
455 LAKESHORE PKWY, ROCK HILL, SC 29730-4205
(803) 909-6363
Mailing address
PO BOX 23321, NEW YORK, NY 10087-3221
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
3668
SC
363A00000X
Physician Assistant
0010-12557
NC
363A00000X
Physician Assistant
0110010017
VA
363A00000X
Physician Assistant
Primary
3668
SC
Other
Enumeration date
08/24/2020
Last updated
03/25/2025
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