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Individual

PROF. JACK A. GOBLE JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
10755 FALLS RD, SUITE 160, LUTHERVILLE, MD 21093-4515
(410) 285-2777
Mailing address
100 LEE ST, STEWARTSTOWN, PA 17363-4061
(717) 578-6660

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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