Provider Demographics
NPI:1154980209
Name:KOHN, ADRIAN (OD)
Entity type:Individual
Prefix:DR
First Name:ADRIAN
Middle Name:
Last Name:KOHN
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:ADRIAN
Other - Middle Name:
Other - Last Name:KUN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OD
Mailing Address - Street 1:186 MARINERS WAY
Mailing Address - Street 2:
Mailing Address - City:MOYOCK
Mailing Address - State:NC
Mailing Address - Zip Code:27958-9049
Mailing Address - Country:US
Mailing Address - Phone:508-320-6685
Mailing Address - Fax:
Practice Address - Street 1:4665 SOUTH BLVD
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1055
Practice Address - Country:US
Practice Address - Phone:757-461-0050
Practice Address - Fax:757-461-4538
Is Sole Proprietor?:No
Enumeration Date:2019-06-12
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT3287152W00000X
MA5694152W00000X
VA0618002770152WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152W00000XEye and Vision Services ProvidersOptometrist