Provider Demographics
NPI:1346243771
Name:COHEN, FELICIA (MD)
Entity Type:Individual
Prefix:DR
First Name:FELICIA
Middle Name:
Last Name:COHEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1075 SW GRANDVIEW AVENUE
Mailing Address - Street 2:STE 200
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97527-5788
Mailing Address - Country:US
Mailing Address - Phone:541-479-8363
Mailing Address - Fax:541-476-2841
Practice Address - Street 1:1075 SW GRANDVIEW AVENUE
Practice Address - Street 2:STE 200
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97527-5788
Practice Address - Country:US
Practice Address - Phone:541-479-8363
Practice Address - Fax:541-476-2841
Is Sole Proprietor?:No
Enumeration Date:2005-05-31
Last Update Date:2015-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD23037207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR287506Medicaid
OR287506Medicaid
ORH53237Medicare UPIN