MEDICARE: KARI LYNN COCHRAN

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
1	363AM0700X	Medical Physician Assistant	1611	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	1611	OTHER	OK	LICENSE

General Provider Information

NPI Number	:	1912197567
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI LYNN COCHRAN

Provider Business Mailing Address
First Line	:	1421 OAKWOOD DR
Second Line	:
City	:	NORMAN
State	:	OK
Zip	:	73069-4446
Country	:	US
Telephone Number	:	405-383-3967
Fax Number	:

Provider Business Practice Location Address
First Line	:	300 WANDA ST
Second Line	:
City	:	MARIETTA
State	:	OK
Zip	:	73448-1200
Country	:	US
Telephone Number	:	580-276-3347
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2007
Last Update Date	:	05/30/2012

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