Provider Demographics
NPI:1063493187
Name:COHEN, VIOLET LOREN (DO)
Entity Type:Individual
Prefix:DR
First Name:VIOLET
Middle Name:LOREN
Last Name:COHEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:VIOLET
Other - Middle Name:COHEN
Other - Last Name:MEYER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:15513 SWALLOWTAIL RD
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73013-1141
Mailing Address - Country:US
Mailing Address - Phone:405-820-9431
Mailing Address - Fax:
Practice Address - Street 1:1025 STRAKA TER
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-2544
Practice Address - Country:US
Practice Address - Phone:405-632-6688
Practice Address - Fax:405-604-0708
Is Sole Proprietor?:No
Enumeration Date:2005-11-07
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK3128208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100018970BMedicaid
OK100018970BMedicaid