Individual
DR. RUDY THEODORE COBB
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
305 COLLEGE ST W, FAYETTEVILLE, TN 37334-2911
(931) 433-2488
(931) 433-2489
Mailing address
305 COLLEGE ST W, FAYETTEVILLE, TN 37334-2911
(931) 433-2488
(931) 433-2489
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
M0011699
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3004292
—
TN
01
—
34725
BCBS OF TN
TN
01
—
40011699
UNITEDHEATHCARE
TN
01
—
61195
BCBS OF AL
TN
Enumeration date
07/21/2006
Last updated
10/22/2010
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