Provider Demographics
NPI:1972532752
Name:KOHM, MARY JANE FRANCESCA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY JANE
Middle Name:FRANCESCA
Last Name:KOHM
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:4800 BELFORT ROAD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:904-483-5850
Mailing Address - Fax:904-483-5860
Practice Address - Street 1:1610 BARRS STREET
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32204
Practice Address - Country:US
Practice Address - Phone:904-387-6750
Practice Address - Fax:904-387-4766
Is Sole Proprietor?:No
Enumeration Date:2006-07-02
Last Update Date:2011-05-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
FLME54929207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL277260400Medicaid
FL277260400Medicaid