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General NPI Number Information
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NPI Number | 1376518688
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Entity Type | Individual
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Provider Name | JOAN MARIE KOHR MD
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Gender | Female
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Dates
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Enumeration Date | 02/21/2006
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Last Update Date | 09/18/2015
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Provider Practice Location Address
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Address Line | 4212 N 16TH ST PHOENIX INDIAN MEDICAL CENTER
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City | PHOENIX
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State | AZ
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Zip | 85016-5319
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Country | US
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Telephone | 602-263-1512
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Fax | 602-200-5387
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Provider Business Mailing Address
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Address Line | 4212 N 16TH ST PHOENIX INDIAN MEDICAL CENTER
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City | PHOENIX
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State | AZ
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Zip | 85016-5319
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Country | US
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Telephone | 602-263-1512
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Fax | 602-200-5387
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 23906
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License Number State | AZ
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