Provider Demographics
NPI:1003918384
Name:COHN, BARBARA SUZANNE (OD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:SUZANNE
Last Name:COHN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 9
Mailing Address - Street 2:
Mailing Address - City:CROW AGENCY
Mailing Address - State:MT
Mailing Address - Zip Code:59022-0009
Mailing Address - Country:US
Mailing Address - Phone:406-638-3342
Mailing Address - Fax:
Practice Address - Street 1:1000 HOSPITAL ROAD
Practice Address - Street 2:CROW INDIAN HEALTH SERVICE- OPTOMETRY
Practice Address - City:CROW AGENCY
Practice Address - State:MT
Practice Address - Zip Code:59022
Practice Address - Country:US
Practice Address - Phone:406-638-3313
Practice Address - Fax:406-638-3341
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2020-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTOPT-OPT-LIC-1938152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MTV12212Medicare UPIN