Dr. Jerry E. Cohron PLLC

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4043 Issued in KY

Legal business name

DR. JERRY E. COHRON PLLC

Practice address

948 Elm St
Suite 2
Bowling Green, KY 42101-2277

Phone

(270) 745-0698

Fax

(270) 745-0067

NPI assigned

Feb 17, 2012

Last updated

Feb 17, 2012By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Elisha D Smith

Title

Office Manager

Phone

(270) 745-0698

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jerry Cohron, PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Bowling Green, KY
  • NPI 1891843504
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1329436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329436800000",
    "number": "1558634808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "948 ELM ST",
            "address_2": "SUITE 2",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421012277",
            "telephone_number": "270-745-0698",
            "fax_number": "270-745-0067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "948 ELM ST",
            "address_2": "SUITE 2",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421012277",
            "telephone_number": "270-745-0698",
            "fax_number": "270-745-0067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JERRY E. COHRON PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-02-17",
        "last_updated": "2012-02-17",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "ELISHA",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "270-745-0698"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "4043",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "4043",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64040439",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60040433",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Oral and Maxillofacial Surgery (Dentist) in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.