Provider Demographics
NPI:1700934684
Name:COHEN, JOEL (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:
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:PO BOX 7904
Mailing Address - Street 2:
Mailing Address - City:CAVE CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85327-7904
Mailing Address - Country:US
Mailing Address - Phone:480-575-0576
Mailing Address - Fax:480-575-0512
Practice Address - Street 1:7010 E ACOMA DR
Practice Address - Street 2:SUITE 102
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-3553
Practice Address - Country:US
Practice Address - Phone:480-575-0576
Practice Address - Fax:480-575-0512
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ29916207R00000X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ640385Medicaid
AZF09622Medicare UPIN
AZ640385Medicaid