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Individual

DR. ALDEN G COCKBURN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1399 WEIMER ROAD, # 600B, TAOS, NM 87571-6351
(505) 751-0334
(505) 751-0297
Mailing address
1399 WEIMER ROAD, # 600B, TAOS, NM 87571-6351
(505) 751-0334
(505) 751-0297

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
MD2004-0101
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00NM009M74
BLUE CROSS BLUE SHIELD
NM
05
29805325
NM
01
MD2004-0101
MEDICAL LIC #
NM
Enumeration date
09/19/2006
Last updated
03/07/2023
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