1275129538 NPI number — ANTHONY STEVEN COSBY JR. ATC

Table of content: ANTHONY STEVEN COSBY JR. ATC (NPI 1275129538)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275129538 NPI number — ANTHONY STEVEN COSBY JR. ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COSBY
Provider First Name:
ANTHONY
Provider Middle Name:
STEVEN
Provider Name Prefix Text:
Provider Name Suffix Text:
JR.
Provider Credential Text:
ATC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1275129538
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
320 EMERGENCY ROOM DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHAPEL HILL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27599-5035
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-966-2281
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
91 STADIUM DR,
Provider Second Line Business Practice Location Address:
STALLINGS EVANS SPORTS MEDICINE CENTER
Provider Business Practice Location Address City Name:
CHAPEL HILL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27514-2751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-962-2067
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/21/2020

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 2255A2300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)