Healthcare Provider Details

I. General information

NPI: 1700934684
Provider Name (Legal Business Name): JOEL COHEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 10/06/2021
Certification Date: 10/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7010 E ACOMA DR SUITE 102
SCOTTSDALE AZ
85254-3553
US

IV. Provider business mailing address

PO BOX 7904
CAVE CREEK AZ
85327-7904
US

V. Phone/Fax

Practice location:
  • Phone: 480-575-0576
  • Fax: 480-575-0512
Mailing address:
  • Phone: 480-575-0576
  • Fax: 480-575-0512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number29916
License Number StateAZ
# 2
Primary TaxonomyY
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number29916
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: