Individual
DR. MAHONEY E COBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4000 KRESGE WAY STE P1503, LOUISVILLE, KY 40207
(502) 456-6212
(502) 456-4440
Mailing address
1169 EASTERN PKWY, SUITE G71, LOUISVILLE, KY 40217-1417
(502) 456-6212
(502) 456-4440
Taxonomy
Speciality
Code
Description
License number
State
207ZB0001X
Blood Banking & Transfusion Medicine Physician
37310
KY
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
37310
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000548820
ANTHEM
KY
01
—
029044500
BLACK LUNG
KY
01
—
11-00338
UHC
KY
01
—
1301279
UMWA
KY
05
—
200896910A
—
IN
01
—
3527415000
PASSPORT ADVANTAGE
KY
01
—
50018022
PASSPORT
KY
05
—
7100030490
—
KY
01
—
P00713837
MEDICARE RR
KY
Enumeration date
02/02/2007
Last updated
12/07/2018
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