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General NPI Number Information
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NPI Number | 1275701310
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Entity Type | Organization
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Legal Business Name | EDWARD ROBERT COHEN
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 7530 HIGHWAY 57 STE A
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City | OCEAN SPRINGS
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State | MS
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Zip | 39565-6512
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Country | US
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Telephone | 228-872-4900
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Fax | 228-872-0803
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Provider Business Mailing Address
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Address Line | 12056 MOBILE AVE
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City | GULFPORT
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State | MS
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Zip | 39503-3004
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Country | US
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Telephone | 228-832-4475
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Fax | 228-832-1512
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWARD ROBERT COHEN
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Credential | DPM
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Telephone | 228-832-4475
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 80055
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License Number State | MS
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