Individual
GARY A COCHRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
118 WEST NORTH ST, KOSCIUSKO, MS 39090
(662) 289-9581
(662) 289-9967
Mailing address
PO BOX 960, KOSCIUSKO, MS 39090-0960
(662) 289-9581
(662) 289-9967
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
19260
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00089021
—
MS
Enumeration date
08/05/2007
Last updated
08/05/2007
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