Individual
KENNETH ALAN COGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
746 N COLLEGE RD, SUITE D, TWIN FALLS, ID 83301-3486
(208) 814-7230
(208) 734-1178
Mailing address
PO BOX 587, TWIN FALLS, ID 83303-0587
(208) 814-7400
(208) 814-7491
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
M10054
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
807994200
—
ID
01
—
P00704141
MCRR
ID
Enumeration date
09/26/2005
Last updated
12/30/2014
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