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General NPI Number Information
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NPI Number | 1891843504
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Entity Type | Individual
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Provider Name | JERRY COHRON PLLC
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Gender | Male
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Dates
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Enumeration Date | 01/08/2007
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Last Update Date | 07/29/2025
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Provider Practice Location Address
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Address Line | 1048 ASHLEY ST STE 103A
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City | BOWLING GREEN
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State | KY
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Zip | 42103-2449
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Country | US
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Telephone | 270-783-0064
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Fax | 270-901-1997
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Provider Business Mailing Address
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Address Line | 1802 ROCKINGHAM AVE
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City | BOWLING GREEN
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State | KY
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Zip | 42104-3348
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Country | US
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Telephone | 270-783-0064
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Fax | 270-901-1997
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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 | 1223P0106X
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Taxonomy Name | Oral and Maxillofacial Pathology Dentistry
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License Number | 4043
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 4043
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License Number State | KY
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