Provider Demographics
NPI:1710967294
Name:COHEN, JONATHAN ADAM (MD)
Entity Type:Individual
Prefix:DR
First Name:JONATHAN
Middle Name:ADAM
Last Name:COHEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 BUSINESS PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GOODLETTSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37072-3132
Mailing Address - Country:US
Mailing Address - Phone:615-851-6033
Mailing Address - Fax:615-851-2018
Practice Address - Street 1:2201 MURPHY AVE STE 101
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1835
Practice Address - Country:US
Practice Address - Phone:615-292-7708
Practice Address - Fax:615-292-7756
Is Sole Proprietor?:No
Enumeration Date:2006-01-19
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN031913174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6028194OtherBCBS TN
TNQ010354Medicaid
TN031913OtherMEDICAL LICENSE
TNBC6520161OtherDEA
TNBC6520161OtherDEA
TNH06779Medicare UPIN