Organization
EDWARD ROBERT COHEN
Active
Other names
dr Edward Robert Cohen
Organization subpart
No
Provider details
NPI number
Authorized official
EDWARD ROBERT COHEN DPM (OWNER)
(228) 832-4475
Entity
Organization
Contact information
Practice address
136 S 15TH AVE, LAUREL, MS 39440-4124
(601) 649-6866
(601) 649-6828
Mailing address
12056 MOBILE AVE, GULFPORT, MS 39503-3004
(228) 832-4475
(228) 832-1512
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
80055
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05859062
—
MS
Enumeration date
02/12/2008
Last updated
04/18/2008
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