Healthcare Provider Details

I. General information

NPI: 1760404230
Provider Name (Legal Business Name): LORI J COHEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2006
Last Update Date: 04/09/2026
Certification Date: 04/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 S NATIONAL AVE
SPRINGFIELD MO
65897-0027
US

IV. Provider business mailing address

901 S NATIONAL AVE
SPRINGFIELD MO
65897-0027
US

V. Phone/Fax

Practice location:
  • Phone: 417-836-4000
  • Fax: 888-586-1348
Mailing address:
  • Phone: 417-836-4000
  • Fax: 888-586-1348

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1999140356
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: