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General NPI Number Information
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NPI Number | 1881654853
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Entity Type | Individual
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Provider Name | KEVIN S COCHRAN M.D.
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Gender | Male
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Dates
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Enumeration Date | 03/24/2006
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Last Update Date | 09/22/2010
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Provider Practice Location Address
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Address Line | 1207 WEST MEDICAL PARK ROAD
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City | AUGUSTA
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State | GA
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Zip | 30909-4504
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Country | US
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Telephone | 706-854-1511
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Fax | 706-854-0542
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Provider Business Mailing Address
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Address Line | 1207 WEST MEDICAL PARK ROAD
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City | AUGUSTA
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State | GA
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Zip | 30909-4504
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Country | US
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Telephone | 706-854-1511
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Fax | 706-854-0542
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 033948
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License Number State | GA
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