Individual
MASON LEE COBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
SRNA
Contact information
Practice address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5000
Mailing address
11 HOLLAND DR, WINDSOR, VA 23487-9218
(757) 374-1860
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
0001277840
VA
171000000X
Military Health Care Provider
Primary
0001277840
VA
Other
Enumeration date
08/02/2024
Last updated
08/03/2024
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