Individual
CHARLES RYAN COSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
58 BIG A RD, TOCCOA, GA 30577-6017
(706) 886-3148
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
12849
GA
207Q00000X
Family Medicine Physician
Primary
99941
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
12849
—
GA
Enumeration date
06/03/2021
Last updated
10/11/2024
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