Basic Information
Provider Information
NPI: 1346212248
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COHEN
FirstName: RODNEY
MiddleName: SCOTT
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 104 FAIRVIEW PARK DR STE 400
Address2:  
City: DUBLIN
State: GA
PostalCode: 310212567
CountryCode: US
TelephoneNumber: 4782771255
FaxNumber: 4783041467
Practice Location
Address1: 1139 LEXINGTON AVE
Address2:  
City: SAVANNAH
State: GA
PostalCode: 314045502
CountryCode: US
TelephoneNumber: 9123034200
FaxNumber:  
Other Information
ProviderEnumerationDate: 02/03/2006
LastUpdateDate: 04/11/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 04/11/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RG0100X73074GAY Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
207RG0100XME62162FLN Allopathic & Osteopathic PhysiciansInternal MedicineGastroenterology

No ID Information.


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