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General NPI Number Information
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NPI Number | 1760413421
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Entity Type | Organization
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Legal Business Name | JEROME A COHN DPM PC
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 03/16/2016
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Provider Practice Location Address
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Address Line | 13555 W MCDOWELL RD SUITE 301
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City | GOODYEAR
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State | AZ
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Zip | 85395-2629
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Country | US
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Telephone | 623-848-0123
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Fax | 623-848-1153
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Provider Business Mailing Address
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Address Line | 13555 W MCDOWELL RD STE 301
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City | GOODYEAR
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State | AZ
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Zip | 85395-2629
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Country | US
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Telephone | 623-848-0123
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Fax | 623-848-1153
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | JOEL T. BOWEN II
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Credential | MD
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Telephone | 623-848-0123
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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