Healthcare Provider Details

I. General information

NPI: 1811044282
Provider Name (Legal Business Name): MICHAEL JOHN KOHRMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2007
Last Update Date: 07/27/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26211 EQUITY DR SUITE A
DAPHNE AL
36526-6189
US

IV. Provider business mailing address

7802 DELTA WOODS DR
BAY MINETTE AL
36507-8167
US

V. Phone/Fax

Practice location:
  • Phone: 251-626-0901
  • Fax: 251-626-0902
Mailing address:
  • Phone: 251-626-0901
  • Fax: 251-626-0902

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number35.057402
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD034146E
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number01052338A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberME 100056
License Number StateFL
# 5
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License NumberMD R8G18
License Number StateMO
# 6
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License NumberMD.29617
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: