Individual
JED E KOHNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA C
Contact information
Practice address
123 HAMILTON ST, CELINA, OH 45822-1909
(419) 586-5760
(419) 586-1257
Mailing address
1140 S KNOXVILLE AVE STE D, SAINT MARYS, OH 45885-2609
(419) 300-1129
(419) 586-1257
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50002151
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0105065
GROUP MEDICAID
OH
05
—
0216503
—
OH
01
—
1184652539
GROUP NPI
OH
01
—
34-1689161
TAX ID
OH
01
—
9934723
GROUP MEDICARE
OH
01
—
H546170
MEDICARE
OH
Enumeration date
08/31/2005
Last updated
02/25/2022
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