Provider Demographics
NPI:1639580798
Name:COBEN, JENNIFER RENEE (MD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:RENEE
Last Name:COBEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 117636
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30368-7636
Mailing Address - Country:US
Mailing Address - Phone:888-856-1878
Mailing Address - Fax:941-484-2200
Practice Address - Street 1:8851 ELLSTREE LN STE 200
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27617-2046
Practice Address - Country:US
Practice Address - Phone:919-282-1100
Practice Address - Fax:919-282-1119
Is Sole Proprietor?:No
Enumeration Date:2014-05-12
Last Update Date:2025-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA80059207W00000X
PAMD467062207W00000X
NC00142207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology