Individual
JARED COHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3551 ROGER BROOKE DR, 3551 ROGER BROOKE DRIVE, JBSA, FORT SAM HOUSTON, TX 78234
(210) 916-8176
Mailing address
310 W LOSEY ST, SCOTT AFB, IL 62225-5250
(618) 256-3454
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0101259136
VA
207R00000X
Internal Medicine Physician
0101259139
VA
207RH0003X
Hematology & Oncology Physician
Primary
2022001802
MO
208D00000X
General Practice Physician
0101259136
VA
Other
Enumeration date
04/10/2014
Last updated
05/02/2024
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