Doctor Name: | DR. WLLIAM STUART COHN |
NPI Number: | 1508148024 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D. |
License Number: | MD-100627 |
Business Practice Address: | 1811 W 66th Ave Gallup, NM - 873016805 |
Business Phone Number: | 8137863101 |
Business Fax Number: | |
Mailing Address: | 1811 West 66 Ave, GALLUP |
State: | NM |
Postal Code: | 873016805 |
Phone Number: | 8137863101 |
Fax Number: | |
NPI Enumeration Date: | 09/10/2011 |
NPI Last Update Date: | 09/10/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | MD-100627 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ZZ |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |