Provider Demographics
NPI:1033285150
Name:COCHRAN, WILLIAM AUSTIN III (PHD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:AUSTIN
Last Name:COCHRAN
Suffix:III
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:287 VALLEY CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2934
Mailing Address - Country:US
Mailing Address - Phone:501-221-1607
Mailing Address - Fax:501-221-2084
Practice Address - Street 1:287 VALLEY CLUB CIR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72212-2934
Practice Address - Country:US
Practice Address - Phone:501-221-1607
Practice Address - Fax:501-221-2084
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR93-13P103G00000X, 103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5T438Medicare ID - Type Unspecified