# DR. JERRY E. COHRON PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558634808
- **Authorized official:** ELISHA D SMITH (OFFICE MANAGER)
- **Authorized official phone:** (270) 745-0698

## Contact information

- **Practice address:** 948 ELM ST, SUITE 2, BOWLING GREEN, KY 42101-2277
- **Practice address phone:** (270) 745-0698
- **Practice address fax:** (270) 745-0067
- **Mailing address:** 948 ELM ST, SUITE 2, BOWLING GREEN, KY 42101-2277
- **Mailing address phone:** (270) 745-0698
- **Mailing address fax:** (270) 745-0067

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 122300000X | Dentist | 4043 | KY | — |
| 1223S0112X | Oral and Maxillofacial Surgery (Dentist) | 4043 | KY | Yes |

## Other

- **Enumeration date:** 02/17/2012
- **Last updated:** 02/17/2012