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General NPI Number Information
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NPI Number | 1417948068
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Entity Type | Individual
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Provider Name | WILLIAM T COCHRAN JR. RPT
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Gender | Male
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Dates
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Enumeration Date | 11/02/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 52 98 PLACE BLVD
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City | HATTIESBURG
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State | MS
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Zip | 39402-8063
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Country | US
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Telephone | 601-296-0199
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Fax | 601-296-0189
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Provider Business Mailing Address
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Address Line | 6068 HIGHWAY 98 SUITE 1196
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City | HATTIESBURG
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State | MS
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Zip | 39402-8861
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Country | US
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Telephone | 601-296-0199
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Fax | 601-296-0189
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT3441
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License Number State | MS
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