Individual
DR. TERRY WESLEY COCHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2000B SOUTH MAIN ST, FAIRFIELD, IA 52556-3740
(641) 472-4156
(641) 472-9436
Mailing address
2000B SOUTH MAIN ST, P.O. BOX 1507, FAIRFIELD, IA 52556-3740
(641) 472-4156
(641) 472-9436
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
25577
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1030676
—
IA
01
—
27519
WELLMARK PIN
IA
Enumeration date
07/31/2006
Last updated
06/17/2009
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