Provider Demographics
NPI:1174752257
Name:KOHN, DANIEL MICHAEL (DO)
Entity type:Individual
Prefix:DR
First Name:DANIEL
Middle Name:MICHAEL
Last Name:KOHN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1146 W STATE ROUTE 89A STE B1
Mailing Address - Street 2:
Mailing Address - City:SEDONA
Mailing Address - State:AZ
Mailing Address - Zip Code:86336-5769
Mailing Address - Country:US
Mailing Address - Phone:928-284-0166
Mailing Address - Fax:928-284-1810
Practice Address - Street 1:1 GUTHRIE SQ
Practice Address - Street 2:
Practice Address - City:SAYRE
Practice Address - State:PA
Practice Address - Zip Code:18840-1625
Practice Address - Country:US
Practice Address - Phone:570-887-2239
Practice Address - Fax:570-887-3285
Is Sole Proprietor?:No
Enumeration Date:2009-07-09
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS015998207Q00000X
AZ006827207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine