MEDICARE: JEFFREY KOEHN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101Y00000X	Counselor	P2007042	AR

General Provider Information

NPI Number	:	1033631510
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY KOEHN

Provider Business Mailing Address
First Line	:	20 CAMBRE CIR
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71909-3419
Country	:	US
Telephone Number	:	901-674-1510
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 CAMBRE CIR
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71909-3419
Country	:	US
Telephone Number	:	901-674-1510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/17/2017
Last Update Date	:	02/13/2026

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