Provider Demographics
NPI:1255525838
Name:COBLE, ANDREW L (MD)
Entity type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:L
Last Name:COBLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:PO BOX 1116
Mailing Address - Street 2:
Mailing Address - City:HARRISON
Mailing Address - State:AR
Mailing Address - Zip Code:72602-1116
Mailing Address - Country:US
Mailing Address - Phone:870-741-6418
Mailing Address - Fax:870-741-5071
Practice Address - Street 1:604 N SPRING STREET
Practice Address - Street 2:
Practice Address - City:HARRISON
Practice Address - State:AR
Practice Address - Zip Code:72601-2952
Practice Address - Country:US
Practice Address - Phone:870-741-6418
Practice Address - Fax:870-741-5071
Is Sole Proprietor?:No
Enumeration Date:2007-08-28
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-7409208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR197043001Medicaid
AR197043001Medicaid