Basic Information
| Provider Information | |||||||||
| NPI: | 1477586113 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COSBY | ||||||||
| FirstName: | STEPHEN | ||||||||
| MiddleName: | L | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 PERKINS SQ | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443081063 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3305438590 | ||||||||
| FaxNumber: | 3305433856 | ||||||||
| Practice Location | |||||||||
| Address1: | 388 S MAIN ST | ||||||||
| Address2: | |||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443111064 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3305438590 | ||||||||
| FaxNumber: | 3305433856 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/08/2006 | ||||||||
| LastUpdateDate: | 11/13/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0804X | 35-051549 | OH | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.