Healthcare Provider Details

I. General information

NPI: 1568471548
Provider Name (Legal Business Name): ALVIN B COHN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: DR. AL COHN

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3127 BLUE LAKE DR
VESTAVIA AL
35243-2305
US

IV. Provider business mailing address

3127 BLUE LAKE DR
VESTAVIA AL
35243-2305
US

V. Phone/Fax

Practice location:
  • Phone: 205-590-9900
  • Fax: 205-383-3112
Mailing address:
  • Phone: 205-590-9900
  • Fax: 205-383-3112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number27053
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: