Basic Information
| Provider Information | |||||||||
| NPI: | 1932251188 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | COSBY | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | MILTON | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3508 CHESHIRE DR | ||||||||
| Address2: | |||||||||
| City: | BIRMINGHAM | ||||||||
| State: | AL | ||||||||
| PostalCode: | 352423100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2059916054 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 33700 HWY 43 | ||||||||
| Address2: | |||||||||
| City: | THOMASVILLE | ||||||||
| State: | AL | ||||||||
| PostalCode: | 367843555 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3346364431 | ||||||||
| FaxNumber: | 3346366129 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/17/2007 | ||||||||
| LastUpdateDate: | 07/21/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207P00000X | 00005955 | AL | Y | Allopathic & Osteopathic Physicians | Emergency Medicine | 207Q00000X | 00005955 | AL | N | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 01471 | 05 | AL | MEDICAID | 01471 | 01 | AL | BLUE CROSS BLUE SHIELD | OTHER |