Healthcare Provider Details

I. General information

NPI: 1760084354
Provider Name (Legal Business Name): RODNEY COCHRAN RPSGT, RST
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2020
Last Update Date: 03/19/2026
Certification Date: 03/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2889 WILD ROSE ST
BUFORD GA
30519-8055
US

IV. Provider business mailing address

2889 WILD ROSE ST
BUFORD GA
30519-8055
US

V. Phone/Fax

Practice location:
  • Phone: 470-243-4050
  • Fax: 470-275-0550
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246Z00000X
TaxonomyOther Specialist/Technologist
License Number5612
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207QS1201X
TaxonomySleep Medicine (Family Medicine) Physician
License Number5612
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: