Individual
SANDRA C KOCHANSKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
620 CROSSOVER RD, TUPELO, MS 38801-4944
(662) 620-7102
(662) 620-7106
Mailing address
PO BOX 980, TUPELO, MS 38802-0980
(662) 620-7102
(662) 620-7106
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
12733
MS
2085R0202X
Diagnostic Radiology Physician
Primary
C-7252
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02178568
—
MS
05
—
150448001
—
AR
01
—
51020
BCBS
AR
01
—
P00060395
RAILROAD MEDICARE
AR
Enumeration date
12/09/2005
Last updated
07/10/2013
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