Provider Demographics
NPI:1760413421
Name:JEROME A COHN DPM PC
Entity Type:Organization
Organization Name:JEROME A COHN DPM PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:JOEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BOWEN
Authorized Official - Suffix:II
Authorized Official - Credentials:MD
Authorized Official - Phone:623-848-0123
Mailing Address - Street 1:13555 W MCDOWELL RD
Mailing Address - Street 2:STE 301
Mailing Address - City:GOODYEAR
Mailing Address - State:AZ
Mailing Address - Zip Code:85395-2629
Mailing Address - Country:US
Mailing Address - Phone:623-848-0123
Mailing Address - Fax:623-848-1153
Practice Address - Street 1:13555 W MCDOWELL RD
Practice Address - Street 2:SUITE 301
Practice Address - City:GOODYEAR
Practice Address - State:AZ
Practice Address - Zip Code:85395-2629
Practice Address - Country:US
Practice Address - Phone:623-848-0123
Practice Address - Fax:623-848-1153
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ29854Medicare PIN
AZ5082160002Medicare NSC