Organization
BOB E COGBURN MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOB E COGBURN MD, PA, DBA (OWNER/PRACTICING PHYSICIAN)
(870) 425-5354
Entity
Organization
Contact information
Practice address
899 BURNETT DR, MOUNTAIN HOME, AR 72653
(870) 425-5354
(870) 425-9656
Mailing address
PO BOX 369, MOUNTAIN HOME, AR 72654
(870) 425-5354
(870) 425-9656
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
C-4698
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113246001
—
AR
Enumeration date
11/17/2009
Last updated
12/14/2009
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