Individual
JOHN COCHRAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5950 UNIVERSITY AVE STE 341, WEST DES MOINES, IA 50266
(515) 875-9800
(515) 875-9804
Mailing address
18350 N MCLEOD WAY, BOISE, ID 83714-8863
(979) 229-0729
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
J5291
TX
208800000X
Urology Physician
M-12670
ID
208800000X
Urology Physician
Primary
MD-46379
IA
208800000X
Urology Physician
MD60515618
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115421304
—
TX
01
—
1881705523
IPN
ID
01
—
1881705523
FCHN
WA
05
—
1881705523
—
ID
05
—
2039604
—
WA
01
—
8G8737
BLUE CROSS
TX
Enumeration date
08/31/2006
Last updated
08/12/2019
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