Doctor Name: | CARLOS MIGUEL COSSIO |
NPI Number: | 1033118781 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 036127 |
Business Practice Address: | 1077 Baxter St Suite K Athens, GA - 306063767 |
Business Phone Number: | 7066130313 |
Business Fax Number: | 7066130229 |
Mailing Address: | 1077 Baxter St, Suite K ATHENS |
State: | GA |
Postal Code: | 306063767 |
Phone Number: | 7066130313 |
Fax Number: | 7066130229 |
NPI Enumeration Date: | 07/15/2005 |
NPI Last Update Date: | 08/17/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/18/2006 |
NPI Reactivation Date: | 04/05/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 036127 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |