Organization
GLENN M COCHRAN OD PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLENN MORGAN COCHRAN OD (OWNER)
(601) 776-6988
Entity
Organization
Contact information
Practice address
303 S ARCHUSA AVE, QUITMAN, MS 39355-0690
(601) 776-6988
(601) 776-6989
Mailing address
PO BOX 690, 303 S ARCHUSA AVE, QUITMAN, MS 39355-0690
(601) 776-6988
(601) 776-6989
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07088019
—
MS
01
—
DS0535
RAILROAD MEDICARE
MS
Enumeration date
11/13/2008
Last updated
06/04/2015
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