Individual
PROF. JACK A. GOBLE JR.
Active
Individual
PROF. JACK A. GOBLE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
MA002128L
PA
363AM0700X
Medical Physician Assistant
Primary
C0001029
MD
Other
Enumeration date
02/17/2012
Last updated
03/05/2013
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