Individual
DR. STEPHEN DUANE COCHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
8355 BAYBERRY RD, JACKSONVILLE, FL 32256-4427
(904) 733-7254
(904) 731-0144
Mailing address
8355 BAYBERRY RD, JACKSONVILLE, FL 32256-4427
(904) 733-7254
(904) 731-0144
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
DN12667
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00583877A
—
GA
05
—
074269400
—
FL
01
—
69399
BLUE CROSS BLUE SHIELD
FL
01
—
825658
UNITED CONCORDIA
FL
Enumeration date
06/25/2008
Last updated
06/25/2008
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