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NPI Code Detail

MEDICARE: WILLIAM N COCHRAN PA-C

MEDICARE: WILLIAM N COCHRAN PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363AM0700XMedical Physician AssistantPA0000000789TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1PA0000000789OTHERTNSTATE LIC NUMBER

General Provider Information

NPI Number : 1417939133
Entity Type Code : Individual
Provider Name (Legal Business Name) : WILLIAM N COCHRAN PA-C
Provider Business Mailing Address
First Line : 1733 NATALIE NEHS DR
Second Line :
City : KNOXVILLE
State : TN
Zip : 37931-4555
Country : US
Telephone Number : 865-384-6630
Fax Number : 865-690-6949
Provider Business Practice Location Address
First Line : 10404 JACKSON OAKS WAY
Second Line :
City : KNOXVILLE
State : TN
Zip : 37922-3293
Country : US
Telephone Number : 865-223-5835
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 08/07/2012

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