MR. Rallie D Cogburn SR., PA

NPI #1548265549 in Macon, Georgia

Provider Information

NPI Number
1548265549
Entity Type
Individual
Name
MR. Rallie D Cogburn SR., PA
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Physician Assistant - Medical
Credential
PA
Enumeration Date
Jun 16, 2005
Last Updated
Oct 3, 2014

Practice Location

Address
6070 LAKESIDE COMMONS DR
City
Macon
State
Georgia
ZIP Code
31210-5778
Phone
(478) 254-2644

Specialties & Taxonomy Codes

Specialty
Physician Assistant - MedicalMedical

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