Individual
BRADLEY M COCHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL CENTER DRIVE, FORT PAYNE, AL 35968
(256) 997-2189
(256) 638-7445
Mailing address
PO BOX 680949, FORT PAYNE, AL 35968-1610
(256) 997-2189
(256) 638-7445
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
21716
AL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009941342
—
AL
01
—
051501857
BC BS OF AL
AL
05
—
051501857
—
AL
01
—
515-39183
BC BS OF AL
AL
Enumeration date
01/22/2007
Last updated
08/15/2014
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