MEDICARE: DR. LEON COCHRAN MD

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	207R00000X	Internal Medicine Physician	MD0000004336	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	080139991	OTHER		RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4147640	OTHER	TN	BCBS OF TN
2	TN0100	OTHER		UNITED HEALTHCARE RIVER V
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	3123351	OTHER		BLUE CROSS PROVIDER NUMBE

General Provider Information

NPI Number	:	1922000157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LEON COCHRAN MD

Provider Business Mailing Address
First Line	:	PO BOX 37087
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21297-3087
Country	:	US
Telephone Number	:	828-687-5616
Fax Number	:	828-650-8076

Provider Business Practice Location Address
First Line	:	1021 COOLIDGE ST
Second Line	:	SUITE 4
City	:	GREENEVILLE
State	:	TN
Zip	:	37743-4672
Country	:	US
Telephone Number	:	423-636-8891
Fax Number	:	423-636-1732

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	06/16/2015

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Directions to “ DR. LEON COCHRAN MD” Practice Location

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