| Dr. Jerry E. Cohron Pllc | |
|
948 Elm St Suite 2 Bowling Green KY 42101-2277 | |
| (270) 745-0698 | |
| (270) 745-0067 |
| Full Name | Dr. Jerry E. Cohron Pllc |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 948 Elm St, Bowling Green, Kentucky |
| Authorized Official Name and Position | Elisha D Smith (OFFICE MANAGER) |
| Authorized Official Contact | 2707450698 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Jerry E. Cohron Pllc 948 Elm St Suite 2 Bowling Green KY 42101-2277 Ph: (270) 745-0698 | Dr. Jerry E. Cohron Pllc 948 Elm St Suite 2 Bowling Green KY 42101-2277 Ph: (270) 745-0698 |
| NPI Number | 1558634808 |
|---|---|
| Provider Enumeration Date | 02/17/2012 |
| Last Update Date | 02/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558634808 | NPI | - | NPPES |
| 60040433 | Medicaid | KY | |
| 64040439 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 4043 (Kentucky) | Secondary |
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | 4043 (Kentucky) | Primary |
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